Imaging prices at Adventist Health Ukiah Valley
Ukiah, 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) range across 2 matching MRF lines |
$181.40–$2,265.20 | $907–$11,326 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$6.80–$131.80 | $34–$659 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$8.80–$185.40 | $44–$927 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$36.20–$703.80 | $181–$3,519 | varies |
| Adrenal Cortex & Medulla Img (78075) | $27.60 | $138 | 0.0× |
| Angio internal mammary (75756) | $42.20 | $211 | 0.0× |
| Angio pulmonary bilat (75743) | $59.60 | $298 | 0.0× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$3,564 | $351–$17,820 | 0.9× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$2,301 | $309–$11,505 | 0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $46.20 | $231 | 0.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $40.60 | $203 | 0.0× |
| Ankle 2 views (73600) range across 12 matching MRF lines |
$4.60–$242.40 | $15–$1,212 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$40.80 | $204 | 0.0× |
| Aortography thoracic w/o serialography rs&i (75600) | $17.60 | $88 | 0.0× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines likely a partial charge, not the full procedure |
$1,757.20 | $364–$8,786 | 0.2× |
| Artery X-Rays Adrenal Gland (75731) | $42.60 | $213 | 0.0× |
| Artery X-Rays Pelvis (75736) | $3,816.20 | $19,081 | 0.5× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$21.40–$32 | $107–$160 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$21.80–$552 | $109–$2,760 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$21.20–$317.20 | $106–$1,586 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$26.40–$323.40 | $132–$1,617 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$7.20–$93 | $36–$465 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$37.20–$919.40 | $186–$4,597 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$23–$460.60 | $115–$2,303 | varies |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$30.60–$607 | $153–$3,035 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$31.40–$798.60 | $157–$3,993 | varies |
| Bone marrow imaging limited area (78102) range across 2 matching MRF lines |
$19.60–$355.80 | $98–$1,779 | varies |
| Bone marrow imaging; multiple areas (78103) range across 2 matching MRF lines |
$23.20–$305.80 | $116–$1,529 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$26.40–$200.20 | $132–$1,001 | varies |
| Brachytx isodose complex (77318) range across 2 matching MRF lines |
$122.60–$377.40 | $613–$1,887 | varies |
| Brain Flow Imaging Only (78610) | $10.80 | $54 | 0.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$1,705.40 | $270–$8,527 | 0.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$96–$985.80 | $480–$4,929 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) | $109.80 | $549 | 0.1× |
| Cat Scan Follow-Up Study (76380) | $35.20 | $176 | 0.3× |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$1,549.20 | $124–$7,746 | 2.2× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$6.80–$150 | $34–$750 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$8.20–$160 | $41–$800 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$10.40–$197.20 | $52–$986 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$11.60–$215 | $58–$1,075 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$12–$172 | $60–$860 | varies |
| Clavicle complete (73000) range across 9 matching MRF lines |
$6.40–$290.80 | $16–$1,454 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$40–$140.40 | $200–$702 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$2,519.20 | $254–$12,596 | 0.6× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$412.20 | $59–$2,061 | 0.9× |
| Contrast X-Ray Of Elbow (73085) | $20.20 | $101 | 0.0× |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$23.80–$572.80 | $119–$2,864 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) range across 2 matching MRF lines |
$21.80–$187.40 | $109–$937 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$37.20–$1,753.80 | $186–$8,769 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$64.60–$1,340.60 | $323–$6,703 | varies |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$23.60–$990 | $118–$4,950 | varies |
| CT abdomen w wo contrast (74170) range across 4 matching MRF lines |
$25.80–$1,093.80 | $129–$5,469 | varies |
| CT abdomen w/o contrast (74150) range across 4 matching MRF lines |
$22–$920.40 | $110–$4,602 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$81.40–$2,051.60 | $407–$10,258 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$67.60–$1,459.80 | $338–$7,299 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$64.80–$1,179.20 | $324–$5,896 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$88.80–$1,122 | $444–$5,610 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$70–$2,155.60 | $350–$10,778 | varies |
| CT Angio Neck (70498) range across 4 matching MRF lines |
$64.80–$1,016.60 | $324–$5,083 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$66.40–$2,423.80 | $332–$12,119 | varies |
| CT bone density (77078) range across 2 matching MRF lines |
$9.20–$416.80 | $46–$2,084 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) range across 2 matching MRF lines |
$136.60–$317 | $683–$1,585 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$45.20–$1,125.40 | $226–$5,627 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$37–$1,042.40 | $185–$5,212 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$47–$1,031 | $235–$5,155 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$43.40–$1,012.20 | $217–$5,061 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$46.40–$1,066.60 | $232–$5,333 | varies |
| CT colonography screening (74263) | $89.60 | $448 | 0.3× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$42–$940 | $210–$4,700 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$47.20–$1,063.80 | $236–$5,319 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$64.40–$896.60 | $322–$4,483 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$21.60–$197.20 | $108–$986 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$42–$1,090 | $210–$5,450 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$47–$1,288.80 | $235–$6,444 | varies |
| CT lower ext w/o (73700) range across 7 matching MRF lines |
$18.60–$1,240.80 | $93–$6,204 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$43–$1,585.20 | $215–$7,926 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$45.20–$1,210.80 | $226–$6,054 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$37–$1,042.40 | $185–$5,212 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$42–$1,202.40 | $210–$6,012 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$32–$774.20 | $160–$3,871 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$60–$888.80 | $300–$4,444 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$47–$1,200 | $235–$6,000 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$47.80–$818.20 | $239–$4,091 | varies |
| CT pelvis w&w/o contrast (72194) range across 3 matching MRF lines |
$22.60–$1,345.60 | $113–$6,728 | varies |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$20.20–$1,022 | $101–$5,110 | varies |
| CT scan of leg combo (73702) range across 5 matching MRF lines |
$22.40–$1,817.40 | $112–$9,087 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$47–$1,089 | $235–$5,445 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$51.20–$920.20 | $256–$4,601 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$47.80–$777.40 | $239–$3,887 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$45.40–$1,181.40 | $227–$5,907 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$37–$1,086.40 | $185–$5,432 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$47.20–$1,280 | $236–$6,400 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$40–$871.40 | $200–$4,357 | varies |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$37–$1,175.20 | $185–$5,876 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 4 matching MRF lines |
$44.80–$1,740 | $224–$8,700 | varies |
| CT upper extremity with contrast (73201) range across 4 matching MRF lines |
$43–$1,542.60 | $215–$7,713 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$87.80–$1,369.40 | $439–$6,847 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$67.40–$1,421 | $337–$7,105 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) range across 2 matching MRF lines |
$64.80–$1,179.20 | $324–$5,896 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$66.40–$1,184.20 | $332–$5,921 | varies |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$1,470.80 | $153–$7,354 | 0.5× |
| Discography Cerv/Thor Spine (72285) | $44 | $220 | 0.0× |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$1,427.60 | $156–$7,138 | 0.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $21.80 | $109 | 0.2× |
| Doppler Fetal Mid Cerebral Artery (76821) | $93 | $465 | 0.7× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$7.40–$376.80 | $37–$1,884 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$7.40–$105.80 | $37–$529 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$27.20–$193.60 | $136–$968 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$71.60–$211 | $358–$1,055 | varies |
| Echograp Trans R Pros Study (76873) | $60.40 | $302 | 0.4× |
| Esophageal Motility Study (78258) range across 2 matching MRF lines |
$26–$327.80 | $130–$1,639 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$22.40–$257.20 | $112–$1,286 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 4 matching MRF lines |
$39.40–$287.40 | $197–$1,437 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$28.60–$284.20 | $143–$1,421 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$370.80 | $59–$1,854 | 1.2× |
| Follow-Up Angiography (75898) | $68.40 | $342 | 0.0× |
| Foot 2 views (73620) range across 10 matching MRF lines |
$5.80–$241.60 | $14–$1,208 | varies |
| Forearm 2 views (73090) range across 10 matching MRF lines |
$6–$313 | $15–$1,565 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$29–$741 | $145–$3,705 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $35.60 | $178 | 0.1× |
| Gastroesophageal Reflux Exam (78262) | $25.40 | $127 | 0.0× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$35.60–$818.80 | $178–$4,094 | varies |
| Gated Heart, Multiple (78473) range across 2 matching MRF lines |
$53.80–$510 | $269–$2,550 | varies |
| Hand 2 views (73120) range across 10 matching MRF lines |
$6.40–$248.40 | $16–$1,242 | varies |
| Heart first pass single,planar (78481) | $35.40 | $177 | 0.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $40 | $200 | 0.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $40.40 | $202 | 0.0× |
| Hepatobil Syst Image W/Drug (78227) range across 4 matching MRF lines |
$33–$987.80 | $82–$4,939 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$27–$987.80 | $135–$4,939 | varies |
| Ht Musc Image Planar Mult (78454) | $49.60 | $248 | 0.0× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$1,412.20 | $250–$7,061 | 0.8× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$14.20–$313.60 | $71–$1,568 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$27.60–$138.40 | $138–$692 | varies |
| Infant hip ultrasound, limited static exam (76886) | $23.20 | $116 | 0.2× |
| Interstitial radiation source applic complex (77778) | $1,822 | $9,110 | 2.0× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$13–$147 | $65–$735 | varies |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$50.80–$1,276.80 | $254–$6,384 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$43.80–$678.80 | $219–$3,394 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$34.60–$855 | $173–$4,275 | varies |
| Kidney Imaging Morphol (78700) range across 2 matching MRF lines |
$644 | $82–$3,220 | 1.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 2 matching MRF lines |
$499.40 | $91–$2,497 | 1.0× |
| Knee 3 Views (73562) range across 8 matching MRF lines |
$7.20–$304.20 | $36–$1,521 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$640 | $90–$3,200 | 1.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $21.40 | $107 | 0.0× |
| Liver imaging static only (78201) range across 2 matching MRF lines |
$1,056.40 | $79–$5,282 | 1.5× |
| Liver imaging w/vascular flow (78202) range across 2 matching MRF lines |
$1,056.40 | $93–$5,282 | 1.5× |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$30–$742.40 | $150–$3,712 | varies |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$26.40–$470.40 | $132–$2,352 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$38.80–$849.20 | $194–$4,246 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$470.40 | $88–$2,352 | 0.9× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$43.20–$803.80 | $216–$4,019 | varies |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) range across 2 matching MRF lines |
$3,451.60 | $202–$17,258 | 0.8× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$54.60–$746.60 | $273–$3,733 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$16.60–$356.60 | $83–$1,783 | varies |
| Mammary ductogram or galactogram single (77053) | $13.40 | $67 | 0.0× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$24.80–$464.80 | $124–$2,324 | varies |
| Mlc imrt design & construction per imrt plan (77338) | $181.40 | $907 | 0.4× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$54.80–$1,565.60 | $274–$7,828 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$44.40–$1,053.60 | $222–$5,268 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$44.40–$1,220 | $222–$6,100 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$55.60–$967.40 | $278–$4,837 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$66.80–$1,288.40 | $334–$6,442 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$44.60–$819 | $223–$4,095 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$64–$1,063.80 | $320–$5,319 | varies |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$27–$943.20 | $135–$4,716 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$60.40–$1,416.60 | $302–$7,083 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$80.20–$1,926 | $401–$9,630 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$60.40–$1,440.40 | $302–$7,202 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$59.40–$796.20 | $297–$3,981 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$53.60–$759.40 | $268–$3,797 | varies |
| MRI cardiac w/o cont stress (75559) | $107.40 | $537 | 0.2× |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$86.60–$637 | $433–$3,185 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$66.80–$1,072 | $334–$5,360 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$55.20–$922.20 | $276–$4,611 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$54.40–$854.80 | $272–$4,274 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$64–$1,016.20 | $320–$5,081 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$84–$1,474 | $420–$7,370 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 4 matching MRF lines |
$60.20–$1,500.60 | $301–$7,503 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 5 matching MRF lines |
$40.20–$1,785 | $201–$8,925 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 5 matching MRF lines |
$25–$1,194.40 | $125–$5,972 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$66.60–$1,152.60 | $333–$5,763 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$85.40–$1,414.20 | $427–$7,071 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$49.80–$694.40 | $249–$3,472 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$60.20–$1,237.80 | $301–$6,189 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$80–$1,532.60 | $400–$7,663 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$64–$963.80 | $320–$4,819 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$81.80–$1,355.80 | $409–$6,779 | varies |
| MRI pelvis w/o contrast (72195) range across 4 matching MRF lines |
$27.20–$876.80 | $136–$4,384 | varies |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$55.20–$1,029.40 | $276–$5,147 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 4 matching MRF lines |
$60.20–$1,333.20 | $301–$6,666 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$50.40–$1,196.40 | $252–$5,982 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$80.20–$1,926 | $401–$9,630 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$81.80–$1,301.60 | $409–$6,508 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$85.40–$1,800 | $427–$9,000 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$66.20–$1,170.80 | $331–$5,854 | varies |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$50.40–$1,194.60 | $252–$5,973 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$80.20–$1,963.20 | $401–$9,816 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$85.40–$1,800 | $427–$9,000 | varies |
| Myelogram Lumbar (72265) | $31.40 | $157 | 0.0× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) range across 2 matching MRF lines |
$25–$429.40 | $125–$2,147 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $36.20 | $181 | 0.0× |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$522.80–$1,826 | $295–$9,130 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$6.80–$152.60 | $34–$763 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $305.80 | $1,529 | 0.6× |
| Nm csf leak detection (78650) | $28.40 | $142 | 0.0× |
| Nm myocard infarct spect (78469) range across 2 matching MRF lines |
$33.80–$420.80 | $169–$2,104 | varies |
| Nm whole blood volume (78122) | $392 | $1,960 | 0.6× |
| Nonvascular Shunt X-Ray (75809) range across 3 matching MRF lines |
$17.80–$149.60 | $89–$748 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $338.40 | $1,692 | 0.2× |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$85–$275 | $425–$1,375 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$65.80–$495.40 | $329–$2,477 | varies |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$44.20–$93.20 | $221–$466 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 3 matching MRF lines |
$24.20–$58 | $121–$290 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $39 | $195 | 0.3× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 3 matching MRF lines |
$6–$9 | $30–$45 | varies |
| Optic foramina (70190) range across 3 matching MRF lines |
$8.40–$108 | $42–$540 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$29.40–$743 | $147–$3,715 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$43.60–$556.20 | $218–$2,781 | varies |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$6.60–$185.20 | $33–$926 | varies |
| Peritoneogram Rs&I (74190) | $17 | $85 | 0.0× |
| Pet Image Skull-Thigh (78812) range across 2 matching MRF lines |
$70–$658.40 | $350–$3,292 | varies |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$79.20–$1,723.80 | $396–$8,619 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$89.40–$2,840 | $447–$14,200 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$88.60–$3,309.40 | $443–$16,547 | varies |
| PET whole body (78813) | $71.20 | $356 | 0.0× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$27–$582 | $135–$2,910 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$12–$285.60 | $60–$1,428 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$446 | $96–$2,230 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 7 matching MRF lines |
$6.60–$283 | $33–$1,415 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 9 matching MRF lines |
$6–$240 | $15–$1,200 | varies |
| Radex elbow complete minimum 3 views (73080) range across 7 matching MRF lines |
$6.60–$309 | $33–$1,545 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$9.80–$204.20 | $49–$1,021 | varies |
| Radex fingr minimum 2 views (73140) range across 7 matching MRF lines |
$5.20–$236.40 | $26–$1,182 | varies |
| Radex foot complete minimum 3 views (73630) range across 7 matching MRF lines |
$6.40–$282 | $32–$1,410 | varies |
| Radex Hand Minimum 3 Views (73130) range across 7 matching MRF lines |
$6.60–$308.40 | $33–$1,542 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$6–$70.80 | $15–$354 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$12.80–$262.40 | $64–$1,312 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 4 matching MRF lines |
$6.60–$156.20 | $16–$781 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$8.40–$172 | $42–$860 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 7 matching MRF lines |
$7.20–$300 | $36–$1,500 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$6.60–$142.60 | $33–$713 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$43.40–$363.60 | $217–$1,818 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$6–$156.80 | $30–$784 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$7.40–$192.60 | $37–$963 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$9–$218.20 | $45–$1,091 | varies |
| Radex Toe Minimum 2 Views (73660) range across 6 matching MRF lines |
$5–$226.20 | $25–$1,131 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 4 matching MRF lines |
$6–$98.60 | $15–$493 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 8 matching MRF lines |
$6.60–$319 | $33–$1,595 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$15.80–$249.60 | $79–$1,248 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$9.60–$317.40 | $48–$1,587 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $10 | $50 | 0.1× |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$46.60–$483.80 | $233–$2,419 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$38.40–$381.80 | $192–$1,909 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$26–$248 | $130–$1,240 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$8.80–$326.80 | $44–$1,634 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$9.60–$216.60 | $48–$1,083 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$30–$403.20 | $150–$2,016 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$19.80–$268.60 | $99–$1,343 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$33.20–$386.20 | $166–$1,931 | varies |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$6.40–$235.60 | $32–$1,178 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$6.80–$286 | $34–$1,430 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$6.40–$235.80 | $32–$1,179 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$16.40–$162.60 | $82–$813 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $6.40 | $32 | 0.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 10 matching MRF lines |
$4.60–$273.60 | $15–$1,368 | varies |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $226.40 | $1,132 | 0.8× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) | $226.40 | $1,132 | 0.8× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) range across 2 matching MRF lines |
$61.80–$226.40 | $309–$1,132 | varies |
| Red Cell Volume Determination Spx 1 Sampling (78120) range across 2 matching MRF lines |
$422.60 | $37–$2,113 | 0.8× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$10.80–$258.20 | $54–$1,291 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$23.80–$551.60 | $119–$2,758 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$26.40–$555 | $132–$2,775 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$36.40–$1,156.40 | $182–$5,782 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$29–$1,225.40 | $145–$6,127 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$39–$1,155 | $195–$5,775 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 2 matching MRF lines |
$75.40–$1,437.80 | $377–$7,189 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $52.60 | $263 | 0.0× |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$73–$250.40 | $365–$1,252 | varies |
| Salivary Gland Imaging (78230) | $16.60 | $83 | 0.0× |
| Scapula (73010) range across 6 matching MRF lines |
$6.80–$308.40 | $34–$1,542 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$11.20–$67.20 | $56–$336 | varies |
| Sella turcica (70240) range across 2 matching MRF lines |
$7.20–$97 | $36–$485 | varies |
| Shoulder 1 view (73020) range across 6 matching MRF lines |
$5.80–$268 | $29–$1,340 | varies |
| Shoulder Arthrography (73040) range across 4 matching MRF lines |
$21.20–$503.80 | $106–$2,519 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$14.20–$215.20 | $71–$1,076 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$6.80–$178.80 | $34–$894 | varies |
| Special dosimetry (77331) | $37 | $185 | 0.2× |
| Special teletherapy port plan (77321) | $40.20 | $201 | 0.1× |
| Special treatment procedure (77470) | $86.20 | $431 | 0.1× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$8.20–$128.80 | $41–$644 | varies |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $64.60 | $323 | 0.6× |
| Tbs technical calculation only (77091) | $64.60 | $323 | 0.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $123 | $615 | 0.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $59.20 | $296 | 0.1× |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$26.60–$484.60 | $133–$2,423 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$66.20–$890.80 | $331–$4,454 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $45.40 | $227 | 0.1× |
| Ther rad simulaj-aided field setting simple (77280) | $30.20 | $151 | 0.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $79.40 | $397 | 0.4× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$7.60–$209 | $38–$1,045 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$8.40–$250.80 | $42–$1,254 | varies |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$8–$207 | $40–$1,035 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $25 | $125 | 0.0× |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$418.20 | $67–$2,091 | 0.8× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$30.40–$735.20 | $152–$3,676 | varies |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$305.80 | $34–$1,529 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$496.40 | $91–$2,482 | 1.0× |
| Tx Devices Design & Construction Complex (77334) | $48.60 | $243 | 0.1× |
| Tx devices design & construction intermediate (77333) | $32 | $160 | 0.2× |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$19.20–$272.20 | $96–$1,361 | varies |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$25.40–$288.60 | $127–$1,443 | varies |
| Ultrasound Elastography Parenchyma (76981) | $22.40 | $112 | 0.2× |
| Ultrasound Exam Aaa Screen (76706) range across 5 matching MRF lines |
$20.20–$228.80 | $101–$1,144 | varies |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$21.80–$310.80 | $109–$1,554 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$18.60–$233.40 | $93–$1,167 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $10 | $50 | 0.1× |
| Unlisted magnetic resonance procedure (76498) | $712.40 | $3,562 | 6.4× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $1,761 | $8,805 | 13.4× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$52.60–$194.60 | $263–$973 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$30–$322.80 | $150–$1,614 | varies |
| Ureteral Reflux Study (78740) range across 2 matching MRF lines |
$21.20–$354 | $106–$1,770 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$12.20–$388.40 | $61–$1,942 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$12.20–$350.40 | $61–$1,752 | varies |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$27.40–$282.60 | $137–$1,413 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$21.20–$231.60 | $106–$1,158 | varies |
| Us complete joint (76881) range across 4 matching MRF lines |
$31.80–$246.40 | $159–$1,232 | varies |
| Us exam, pelvic, limited (76857) range across 5 matching MRF lines |
$18.60–$193.60 | $93–$968 | varies |
| Us head (76506) range across 2 matching MRF lines |
$23.60–$145.60 | $118–$728 | varies |
| Us kidney transplant (76776) range across 3 matching MRF lines |
$28.20–$432.60 | $141–$2,163 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$25.80–$280.80 | $129–$1,404 | varies |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$71–$722.40 | $355–$3,612 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$24.20–$251.80 | $121–$1,259 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$28–$261.20 | $140–$1,306 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$25.60–$298.60 | $128–$1,493 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 4 matching MRF lines |
$37–$298.20 | $185–$1,491 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 4 matching MRF lines |
$32–$140.80 | $160–$704 | varies |
| Us retroperitoneal complete (76770) range across 4 matching MRF lines |
$27.40–$307.80 | $137–$1,539 | varies |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$21.60–$259.60 | $108–$1,298 | varies |
| Us scrotum and contents (76870) range across 4 matching MRF lines |
$23.80–$283.80 | $119–$1,419 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$48–$145.60 | $240–$728 | varies |
| Us thyroid (76536) range across 4 matching MRF lines |
$21–$256.80 | $105–$1,284 | varies |
| Us transrectal (76872) range across 4 matching MRF lines |
$25.40–$164.60 | $127–$823 | varies |
| Vascular Flow Imaging (78445) range across 2 matching MRF lines |
$498.40 | $92–$2,492 | 1.0× |
| Vein X-Ray Chest (75827) | $40.60 | $203 | 0.0× |
| Venogram Sinus/Jugular (75860) | $41.60 | $208 | 0.0× |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$2,301 | $203–$11,505 | 0.6× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$2,031.40 | $264–$10,157 | 1.0× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$37.60–$728.80 | $188–$3,644 | varies |
| Venography Renal Bilateral (75833) | $52.80 | $264 | 0.0× |
| Venography Renal Unilateral (75831) | $39.60 | $198 | 0.0× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$19.60 | $98 | 0.0× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $33.60 | $168 | 0.1× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$6.40–$81.40 | $32–$407 | varies |
| Wrist 2 views (73100) range across 10 matching MRF lines |
$4.80–$250.20 | $16–$1,251 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$7.20–$196.20 | $36–$981 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$19–$369.60 | $95–$1,848 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$3,451.60 | $357–$17,258 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$8.40–$175.40 | $42–$877 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 10 matching MRF lines |
$4.80–$293.80 | $16–$1,469 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$399.80 | $59–$1,999 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$9.80–$159 | $49–$795 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines |
$11.80–$196 | $59–$980 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$13.60–$208.80 | $68–$1,044 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$7.20–$190 | $36–$950 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$8.40–$206.20 | $42–$1,031 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$10.40–$253.20 | $52–$1,266 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 4 matching MRF lines |
$8.40–$208.80 | $42–$1,044 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 3 matching MRF lines |
$11.20–$227 | $56–$1,135 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$11.80–$286.60 | $59–$1,433 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$11.60–$304.40 | $58–$1,522 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$8.40–$214.60 | $42–$1,073 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$11.20–$306.60 | $56–$1,533 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$10–$251.80 | $50–$1,259 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$6.80–$139 | $34–$695 | varies |
| X-ray humerus (73060) range across 10 matching MRF lines |
$4.60–$296.20 | $15–$1,481 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$18–$769.40 | $90–$3,847 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$18.20–$779.20 | $91–$3,896 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$6.80–$153 | $34–$765 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$6.60–$142 | $33–$710 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$8.40–$206.40 | $42–$1,032 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$6.80–$73.40 | $34–$367 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$12–$351.40 | $60–$1,757 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$8.40–$173.20 | $42–$866 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$6.60–$137.40 | $33–$687 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 4 matching MRF lines |
$6.60–$186.40 | $16–$932 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$8.20–$202.20 | $41–$1,011 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$10.60–$272.20 | $53–$1,361 | varies |
| X-Ray Stress View (77071) | $44.40 | $222 | 0.4× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$9.20–$260 | $46–$1,300 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$6.80–$209.80 | $34–$1,049 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$19.40–$598.40 | $97–$2,992 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$10.20–$154 | $51–$770 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$20.60–$330 | $103–$1,650 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$10.40–$237.40 | $52–$1,187 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$7.60–$178 | $38–$890 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$6.80–$1,139.80 | $34–$5,699 | varies |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$10.60–$186.80 | $53–$934 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$21.60–$230.80 | $108–$1,154 | 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.