Imaging prices at Adventist Health White Memorial Montebello
Montebello, CA · every code in this section with a posted price and a Medicare benchmark.
365 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 |
$172.26–$1,650.24 | $957–$9,168 | varies |
| Abdomen 1 View (74018) | $180.54 | $1,003 | 1.6× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$186.12–$225.36 | $1,034–$1,252 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $891 | $4,950 | 1.7× |
| Angio internal mammary (75756) | $928.80 | $5,160 | 0.2× |
| Angio pulmonary bilat (75743) | $2,192.58 | $12,181 | 0.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,088.18 | $11,601 | 0.5× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$3,020.40 | $369–$16,780 | 0.7× |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$2,059.38–$2,745.72 | $325–$15,254 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,898.28 | $10,546 | 0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$934.56 | $213–$5,192 | 0.2× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$117.54–$235.26 | $653–$1,307 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,306.52 | $12,814 | 0.3× |
| Aortography thoracic w/o serialography rs&i (75600) | $2,306.52 | $12,814 | 0.6× |
| Artery X-Rays Abdomen (75726) | $3,826.44 | $21,258 | 0.5× |
| Artery X-Rays Adrenal Gland (75731) | $1,898.28 | $10,546 | 0.5× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,552.40 | $14,180 | 0.4× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$2,924.46 | $16,247 | 0.4× |
| Arthrogram ankle (73615) | $343.98 | $1,911 | 0.8× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$20.70–$873 | $115–$4,850 | varies |
| Arthrogram Wrist (73115) | $544.50 | $3,025 | 1.2× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$25.02–$158.76 | $139–$882 | varies |
| Bone age studies (77072) | $176.22 | $979 | 1.3× |
| Bone Imaging 3 Phase (78315) | $982.62 | $5,459 | 1.9× |
| Bone Imaging Limited Area (78300) | $888.84 | $4,938 | 1.7× |
| Bone Imaging Multiple Areas (78305) | $546.48 | $3,036 | 1.1× |
| Bone Imaging Whole Body (78306) | $1,119.78 | $6,221 | 2.2× |
| Bone marrow imaging; whole body (78104) | $403.20 | $2,240 | 0.8× |
| Bone survey infant (77076) | $359.28 | $1,996 | 2.7× |
| Brachytx isodose complex (77318) range across 2 matching MRF lines |
$116.46–$542.52 | $647–$3,014 | varies |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$73.62–$444.42 | $409–$2,469 | varies |
| Brachytx Isodose Plan Simple (77316) range across 2 matching MRF lines |
$56.16–$395.10 | $312–$2,195 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $670.68 | $3,726 | 1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,154.32 | $17,524 | 1.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,783.98 | $9,911 | 4.0× |
| Cat Scan Follow-Up Study (76380) | $352.98 | $1,961 | 3.2× |
| Cerebrospinal Fluid Scan (78630) | $824.76 | $4,582 | 1.2× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$6.48–$197.10 | $36–$1,095 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$7.74–$243.90 | $43–$1,355 | varies |
| Chest 3 views (71047) | $333.36 | $1,852 | 3.0× |
| Chest 4 or more views (71048) | $384.66 | $2,137 | 2.9× |
| Cholecystography Oral Contrast (74290) | $164.16 | $912 | 0.7× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$137.70–$275.40 | $765–$1,530 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $94.32 | $524 | 0.7× |
| Continuing medical physics consltj pr wk (77336) | $424.98 | $2,361 | 2.5× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$3,294 | $267–$18,300 | 0.8× |
| Contrast X-Ray Bladder (74430) | $389.34 | $2,163 | 0.9× |
| Contrast X-Ray Of Knee Joint (73580) | $564.84 | $3,138 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) | $2,781.36 | $15,452 | 6.2× |
| CT abdomen and pelvis without contrast (74176) | $2,113.56 | $11,742 | 6.9× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,100.34–$1,467.18 | $6,113–$8,151 | varies |
| CT abdomen w wo contrast (74170) | $1,833.66 | $10,187 | 8.1× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$880.56–$1,173.96 | $4,892–$6,522 | varies |
| CT Angio Abdomen and Pelvis (74174) | $2,641.68 | $14,676 | 5.9× |
| CT Angio Chest (71275) | $1,591.92 | $8,844 | 7.1× |
| CT Angio Head (70496) | $1,344.42 | $7,469 | 6.0× |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$83.88–$1,147.68 | $466–$6,376 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$2,033.46–$3,050.28 | $11,297–$16,946 | varies |
| CT Angio Neck (70498) | $1,463.40 | $8,130 | 6.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,466.82–$2,200.32 | $8,149–$12,224 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $352.98 | $1,961 | 1.6× |
| CT cervical spine w/ contrast (72126) | $2,087.10 | $11,595 | 4.7× |
| CT cervical spine w/o contrast (72125) | $1,670.04 | $9,278 | 12.4× |
| CT cervical spine w/wo cont (72127) | $2,295.90 | $12,755 | 10.2× |
| CT chest w contrast (71260) | $1,771.92 | $9,844 | 7.9× |
| CT chest w/wo contrast (71270) | $1,949.58 | $10,831 | 8.6× |
| CT head/brain with contrast (70460) | $1,858.86 | $10,327 | 8.2× |
| CT head/brain without and with contrast (70470) | $2,044.80 | $11,360 | 9.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $60.84 | $338 | 0.1× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$20.34–$1,046.70 | $113–$5,815 | varies |
| CT iac w contrast (70481) | $1,346.94 | $7,483 | 6.0× |
| CT l-spine w&w/o contrast (72133) | $2,260.80 | $12,560 | 10.0× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$976.14–$1,952.28 | $5,423–$10,846 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,627.38–$2,441.34 | $9,041–$13,563 | varies |
| CT lumbar spine w contrast (72132) | $2,055.24 | $11,418 | 4.6× |
| CT lumbar spine w/o contrast (72131) | $1,644.12 | $9,134 | 12.2× |
| CT maxillofacial w contrast (70487) | $1,485 | $8,250 | 6.6× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$891.18–$1,188.18 | $4,951–$6,601 | varies |
| CT neck tissue combo (70492) | $1,778.58 | $9,881 | 7.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,728.18 | $9,601 | 7.7× |
| CT orbits w/o contrast (70480) | $1,100.70 | $6,115 | 8.2× |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$42.66–$1,669.14 | $237–$9,273 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$910.26–$1,213.74 | $5,057–$6,743 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,033.46–$3,050.28 | $11,297–$16,946 | varies |
| CT scans face/jaw combo (70488) | $1,633.68 | $9,076 | 7.2× |
| CT soft tissue neck w contrast (70491) | $1,616.40 | $8,980 | 7.2× |
| CT soft tissue neck w/o contrast (70490) | $1,293.12 | $7,184 | 9.6× |
| CT thoracic spine w contrast (72129) | $1,934.10 | $10,745 | 8.6× |
| CT thoracic spine w/o contrast (72128) | $1,547.46 | $8,597 | 11.5× |
| CT thoracic spine w/wo cont (72130) | $2,127.24 | $11,818 | 9.4× |
| CT thorax w/o contrast (71250) | $1,189.44 | $6,608 | 8.8× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$905.94–$1,812.06 | $5,033–$10,067 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,832.58–$2,748.78 | $10,181–$15,271 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,466.10–$2,199.24 | $8,145–$12,218 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,058.76 | $5,882 | 4.7× |
| Cta Abdomen (74175) | $784.44 | $4,358 | 3.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,344.42 | $7,469 | 3.0× |
| CTA pelvis (72191) | $1,188.54 | $6,603 | 5.3× |
| Dilation ureters/urethra rs&i (74485) | $1,152.18 | $6,401 | 0.4× |
| Diskography lumbar (72295) | $1,326.42 | $7,369 | 0.5× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$297.90–$298.08 | $1,655–$1,656 | varies |
| Echograp Trans R Pros Study (76873) range across 2 matching MRF lines |
$57.06–$222.30 | $317–$1,235 | varies |
| Esophagram (74220) | $309.06 | $1,717 | 1.4× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$310.68–$414.18 | $1,726–$2,301 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $321.84 | $1,788 | 2.4× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$358.20 | $62–$1,990 | 1.2× |
| Follow-Up Angiography (75898) | $900.72 | $5,004 | 0.2× |
| Foot 2 views (73620) range across 7 matching MRF lines |
$126.72–$268.74 | $704–$1,493 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$135.72–$271.44 | $754–$1,508 | varies |
| Gastric emptying imaging study (78264) | $939.96 | $5,222 | 1.8× |
| Gastroesophageal Reflux Exam (78262) | $699.48 | $3,886 | 1.4× |
| Gated Heart Planar Single (78472) | $1,102.50 | $6,125 | 2.1× |
| Gated Heart, Multiple (78473) | $595.44 | $3,308 | 1.2× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$158.40–$237.60 | $880–$1,320 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) range across 2 matching MRF lines |
$215.46–$722.88 | $1,197–$4,016 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$152.82–$2,049.66 | $849–$11,387 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 2 matching MRF lines |
$78.48–$1,081.98 | $436–$6,011 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,923.66 | $10,687 | 0.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,898.28 | $10,546 | 0.5× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$807.30–$1,076.40 | $4,485–$5,980 | varies |
| Hepatobiliary System Imaging (78226) | $831.78 | $4,621 | 1.6× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$1,743.48 | $262–$9,686 | 1.0× |
| Hysterosalpingogram (74740) | $394.56 | $2,192 | 1.3× |
| Image fusion (77399) | $4.86 | $27 | 0.0× |
| Interstitial radiation source applic complex (77778) | $1,394.64 | $7,748 | 1.6× |
| Intracavitary Radiation Source Applic Complex (77763) | $520.74 | $2,893 | 0.6× |
| Intracavitary Radiation Source Applic Intermed (77762) | $287.28 | $1,596 | 0.4× |
| Intracavitary radiation source applic simple (77761) | $215.64 | $1,198 | 0.3× |
| K Flow/Funct Image Multiple (78709) | $931.14 | $5,173 | 1.3× |
| K Flow/Funct Image W/Drug (78708) | $1,043.10 | $5,795 | 1.5× |
| K Flow/Funct Image W/O Drug (78707) | $1,244.34 | $6,913 | 1.8× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $977.22 | $5,429 | 1.9× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$197.46–$311.58 | $1,097–$1,731 | varies |
| Liver & Spleen Imaging Static Only (78215) | $755.64 | $4,198 | 1.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $928.44 | $5,158 | 1.8× |
| Liver imaging w/vascular flow (78202) | $747.18 | $4,151 | 1.1× |
| Lung Perf&Ventilat Diferentl (78598) | $826.38 | $4,591 | 1.2× |
| Lung perfusion differential (78597) | $660.42 | $3,669 | 1.3× |
| Lung Ventilat&Perfus Imaging (78582) | $991.62 | $5,509 | 1.4× |
| Lung Ventilation Imaging (78579) | $402.66 | $2,237 | 0.8× |
| Lymph System Imaging (78195) | $1,418.04 | $7,878 | 2.0× |
| Magnetic Image Jaw Joint (70336) | $1,736.28 | $9,646 | 5.7× |
| Meckels Divert Exam (78290) | $795.78 | $4,421 | 1.5× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$172.26–$676.62 | $957–$3,759 | varies |
| Mra Head W/O & W/Contrast Material (70546) | $2,544.48 | $14,136 | 5.7× |
| MRA head w/o contrast (70544) | $1,751.76 | $9,732 | 5.7× |
| MRA head with contrast (70545) | $1,883.16 | $10,462 | 4.2× |
| MRA neck w contrast (70548) | $1,883.16 | $10,462 | 4.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,544.48 | $14,136 | 5.7× |
| MRA neck w/o contrast (70547) | $1,751.76 | $9,732 | 5.7× |
| MRI abdomen w contrast (74182) | $2,644.02 | $14,689 | 5.9× |
| MRI abdomen w/o contrast (74181) | $2,115.72 | $11,754 | 6.9× |
| MRI any jt lower extrem w/contrast material (73722) | $2,210.76 | $12,282 | 2.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,763–$4,144.50 | $15,350–$23,025 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,448.46 | $8,047 | 1.4× |
| MRI brain functional w/physician admnistration (70555) | $375.48 | $2,086 | 1.2× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$1,673.82–$2,231.64 | $9,299–$12,398 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,339.02–$1,785.42 | $7,439–$9,919 | varies |
| MRI chest w/o contrast (71550) | $1,240.20 | $6,890 | 4.0× |
| MRI chest with contrast (71551) | $1,549.80 | $8,610 | 1.5× |
| MRI chest wo w contrast (71552) | $1,746.18 | $9,701 | 3.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,566 | $8,700 | 3.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,859.40–$2,789.10 | $10,330–$15,495 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$1,076.04–$2,151.90 | $5,978–$11,955 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$1,703.52–$2,271.24 | $9,464–$12,618 | varies |
| Mri Neck Spine W/O & W/Dye (72156) | $2,454.84 | $13,638 | 5.5× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,448.10–$1,930.86 | $8,045–$10,727 | varies |
| MRI orbit face neck w contrast (70542) | $2,413.62 | $13,409 | 5.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,775.06 | $15,417 | 6.2× |
| MRI pelvis w contrast (72196) | $1,805.40 | $10,030 | 4.0× |
| MRI pelvis w/o & w contrast (72197) | $1,985.58 | $11,031 | 4.4× |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,133.28–$1,510.92 | $6,296–$8,394 | varies |
| MRI spectroscopy (76390) | $1,717.38 | $9,541 | 15.3× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,022.76–$1,363.68 | $5,682–$7,576 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,656 | $9,200 | 3.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,465.02–$2,197.62 | $8,139–$12,209 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,104.38 | $11,691 | 4.7× |
| MRI, abdomen, combo (74183) | $3,305.34 | $18,363 | 7.4× |
| MRI, dorsal spine combo (72157) | $1,894.14 | $10,523 | 4.2× |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$1,407.06–$1,875.96 | $7,817–$10,422 | varies |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$935.82–$1,871.64 | $5,199–$10,398 | varies |
| MRI, joint upper extrem combo (73223) | $2,020.32 | $11,224 | 4.5× |
| MRI, lumbar spine combo (72158) | $2,498.40 | $13,880 | 5.6× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $447.48 | $2,486 | 0.9× |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$288.72–$1,800.18 | $309–$10,001 | varies |
| N-invas est c ffr sw aly CTA (75580) | $473.76 | $2,632 | 0.4× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$189.72–$202.86 | $1,054–$1,127 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $279.72 | $1,554 | 0.6× |
| Nm csf leak detection (78650) | $26.64 | $148 | 0.0× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$321.12–$1,743.66 | $1,784–$9,687 | varies |
| Nuclear Rx Oral Admin (79005) | $1,024.56 | $5,692 | 3.4× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $294.66 | $1,637 | 1.7× |
| Optic foramina (70190) range across 2 matching MRF lines |
$105.84–$158.76 | $588–$882 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $638.64 | $3,548 | 0.9× |
| Parathyroid Planar Imaging (78070) | $1,030.86 | $5,727 | 2.0× |
| Parathyroid planar imaging w/wo subtraction (78071) | $594.54 | $3,303 | 1.2× |
| Pelvis 1 or 2 views (72170) | $191.34 | $1,063 | 1.4× |
| Pet Image Skull-Thigh (78812) | $2,483.28 | $13,796 | 1.4× |
| Pet Image W/Ct Lmtd (78814) | $3,721.68 | $20,676 | 2.0× |
| PET image w/CT, full body (78816) | $3,031.38 | $16,841 | 1.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,517.38 | $19,541 | 1.9× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $2,327.58 | $12,931 | 1.4× |
| PET whole body (78813) | $2,638.08 | $14,656 | 1.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,938.06 | $10,767 | 0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $931.32 | $5,174 | 1.8× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $513.36 | $2,852 | 0.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $315.72 | $1,754 | 2.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $333.18 | $1,851 | 0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$212.94–$319.50 | $1,183–$1,775 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$167.76–$251.64 | $932–$1,398 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$250.74–$376.20 | $1,393–$2,090 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$326.88–$338.40 | $1,816–$1,880 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$128.16–$227.88 | $712–$1,266 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$217.98–$327.06 | $1,211–$1,817 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$197.82–$305.64 | $1,099–$1,698 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$140.94–$187.92 | $783–$1,044 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $188.64 | $1,048 | 1.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$187.38–$249.84 | $1,041–$1,388 | varies |
| Radex Ribs Unilateral 2 Views (71100) | $206.64 | $1,148 | 1.8× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$223.56–$335.34 | $1,242–$1,863 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $235.80 | $1,310 | 2.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $229.14 | $1,273 | 1.0× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$102.60–$192.96 | $570–$1,072 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$220.32–$231.48 | $1,224–$1,286 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $318.06 | $1,767 | 2.8× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$161.28–$241.92 | $896–$1,344 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$117.54–$156.78 | $653–$871 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$246.60–$369.90 | $1,370–$2,055 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$288–$653.22 | $1,600–$3,629 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $10,314.72 | $57,304 | 1.1× |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$193.50–$453.42 | $1,075–$2,519 | varies |
| Radiation treatment delivery level 2 (77407) | $731.34 | $4,063 | 1.5× |
| Radiation treatment delivery level 3 (77412) | $1,047.60 | $5,820 | 1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $309.06 | $1,717 | 2.3× |
| Radiologic exam colon double contrast study (74280) | $682.38 | $3,791 | 3.0× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$449.10–$598.86 | $2,495–$3,327 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $231.66 | $1,287 | 1.0× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$263.88–$396 | $1,466–$2,200 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$239.76–$274.14 | $1,332–$1,523 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $472.50 | $2,625 | 2.1× |
| Radiologic exam swallow function contrast study (74230) | $339.48 | $1,886 | 1.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $470.88 | $2,616 | 2.1× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$158.22–$237.42 | $879–$1,319 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$248.94–$373.50 | $1,383–$2,075 | varies |
| Radiologic examination knee 1/2 views (73560) range across 5 matching MRF lines |
$9–$260.28 | $50–$1,446 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $553.86 | $3,077 | 4.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$141.30–$282.78 | $785–$1,571 | varies |
| Renal Cyst Study (74470) | $309.24 | $1,718 | 0.4× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$291.78–$293.40 | $1,621–$1,630 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $821.16 | $4,562 | 1.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,347.30 | $7,485 | 1.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,900.80 | $10,560 | 2.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,623.06 | $9,017 | 2.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,179.80 | $12,110 | 1.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,116.98 | $11,761 | 1.3× |
| Rp Therapy Intravenous Administration (79101) | $68.76 | $382 | 0.2× |
| Scapula (73010) range across 3 matching MRF lines |
$129.96–$282.78 | $722–$1,571 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $16.20 | $90 | 0.7× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$108.72–$225.72 | $604–$1,254 | varies |
| Shoulder Arthrography (73040) | $499.68 | $2,776 | 1.1× |
| Sialogram (70390) | $435.96 | $2,422 | 1.4× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$214.20–$294.66 | $1,190–$1,637 | varies |
| Special dosimetry (77331) range across 2 matching MRF lines |
$35.10–$120.78 | $195–$671 | varies |
| Special Physics Consult (77370) | $534.60 | $2,970 | 3.1× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$38.16–$344.52 | $212–$1,914 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$81.72–$638.82 | $454–$3,549 | varies |
| Stereotactic Body Radiation Delivery (77373) | $4,733.10 | $26,295 | 2.1× |
| Sternoclavicular joints (71130) | $207.54 | $1,153 | 1.9× |
| Superior sagittal sinus venogram (75870) | $1,742.04 | $9,678 | 0.4× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $225.90 | $1,255 | 1.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$116.64–$364.50 | $648–$2,025 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$56.16–$129.60 | $312–$720 | varies |
| Testicular Imaging W/Flow (78761) | $587.16 | $3,262 | 1.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$62.82–$384.66 | $349–$2,137 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$43.02–$114.66 | $239–$637 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$28.62–$204.66 | $159–$1,137 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $206.64 | $1,148 | 0.9× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$132.66–$238.86 | $737–$1,327 | varies |
| Thoracic spine 3 views (72072) | $446.58 | $2,481 | 3.3× |
| Thoracolumbar 2 views (72080) | $288 | $1,600 | 2.6× |
| Thyroid Imaging With Vascular Flow (78013) | $172.80 | $960 | 0.3× |
| Thyroid Met Imaging Body (78018) | $968.58 | $5,381 | 1.4× |
| Thyroid Uptake Measurement (78012) | $183.78 | $1,021 | 0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $461.16 | $2,562 | 0.9× |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$46.08–$303.48 | $256–$1,686 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$30.42–$268.20 | $169–$1,490 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$18.18–$240.12 | $101–$1,334 | varies |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$153.90–$448.74 | $855–$2,493 | varies |
| Ultrasound Exam Aaa Screen (76706) | $410.76 | $2,282 | 3.1× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$306.18–$500.22 | $1,701–$2,779 | varies |
| Unlis px ther radiol clinical tx planning (77299) | $50.22 | $279 | 0.3× |
| Unlisted Dx Radiographic Procedure (76499) | $217.26 | $1,207 | 1.9× |
| Unlisted magnetic resonance procedure (76498) | $1,405.08 | $7,806 | 12.6× |
| Unlisted us procedure (76999) | $357.12 | $1,984 | 3.2× |
| Upper gi w/o kub (74240) | $381.96 | $2,122 | 1.7× |
| Ureteral Reflux Study (78740) | $577.98 | $3,211 | 1.1× |
| Urethrocystogram voiding (74455) | $401.94 | $2,233 | 1.3× |
| Urethrocystography retrograde (74450) | $558.54 | $3,103 | 1.8× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$204.48–$352.08 | $1,136–$1,956 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$124.20–$343.08 | $690–$1,906 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$31.86–$428.94 | $177–$2,383 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$190.62–$280.44 | $1,059–$1,558 | varies |
| Us head (76506) | $162 | $900 | 1.2× |
| Us kidney transplant (76776) | $545.58 | $3,031 | 4.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$24.30–$509.04 | $135–$2,828 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$312.30–$475.20 | $1,735–$2,640 | varies |
| Us ob limited 1 or more fetuses (76815) | $370.26 | $2,057 | 2.8× |
| Us ob transvaginal (76817) | $364.32 | $2,024 | 2.7× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$538.20–$538.56 | $2,990–$2,992 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $420.84 | $2,338 | 3.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $104.04 | $578 | 0.8× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$201.78–$423.72 | $1,121–$2,354 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$465.30–$465.48 | $2,585–$2,586 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$385.20–$490.68 | $2,140–$2,726 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$366.66–$431.28 | $2,037–$2,396 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$23.94–$316.80 | $133–$1,760 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$1,409.58 | $213–$7,831 | 0.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $934.56 | $5,192 | 0.2× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$1,753.02 | $437–$9,739 | 0.4× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$2,517.48 | $213–$13,986 | 0.6× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$50.04–$976.50 | $278–$5,425 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$887.58 | $197–$4,931 | 0.4× |
| Venography Renal Bilateral (75833) | $1,689.30 | $9,385 | 0.4× |
| Venography Renal Unilateral (75831) | $2,303.46 | $12,797 | 0.6× |
| Wrist 2 views (73100) range across 7 matching MRF lines |
$134.64–$296.28 | $748–$1,646 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $208.08 | $1,156 | 1.9× |
| X-ray antegrade pyelogram tube (74425) | $369.72 | $2,054 | 0.8× |
| X-Ray Aorta Leg Arteries (75630) | $3,294 | $18,300 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$165.42–$428.04 | $919–$2,378 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 8 matching MRF lines |
$116.46–$300.60 | $647–$1,670 | varies |
| X-Ray Exam Breast Specimen (76098) | $387.54 | $2,153 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$74.16–$210.06 | $412–$1,167 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$144.54–$292.14 | $803–$1,623 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$226.44–$371.16 | $1,258–$2,062 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$133.56–$148.32 | $742–$824 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$196.92–$269.28 | $1,094–$1,496 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$204.84–$301.32 | $1,138–$1,674 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$295.02–$301.32 | $1,639–$1,674 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$312.48–$452.88 | $1,736–$2,516 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$459.54–$525.06 | $2,553–$2,917 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $456.66 | $2,537 | 3.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$214.38–$242.10 | $1,191–$1,345 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$258.48–$407.88 | $1,436–$2,266 | varies |
| X-ray eye for foreign body (70030) | $127.44 | $708 | 1.1× |
| X-ray humerus (73060) range across 6 matching MRF lines |
$128.88–$298.80 | $716–$1,660 | varies |
| X-ray IV pyelogram (ivp) (74400) | $369.72 | $2,054 | 1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $257.40 | $1,430 | 2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$77.76–$188.82 | $432–$1,049 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$237.60–$284.22 | $1,320–$1,579 | varies |
| X-ray nose-rectum child f.b. (76010) | $160.20 | $890 | 1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$350.28–$414 | $1,946–$2,300 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$219.96–$243.90 | $1,222–$1,355 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$124.92–$168.48 | $694–$936 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$206.64–$275.40 | $1,148–$1,530 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$185.40–$308.88 | $1,030–$1,716 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$366.84–$403.02 | $2,038–$2,239 | varies |
| X-Ray Stress View (77071) | $50.04 | $278 | 0.4× |
| X-ray thoracic spine 4 vw (72074) | $558.72 | $3,104 | 4.2× |
| X-Ray Tmj Unilat (70328) | $92.52 | $514 | 0.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $559.80 | $3,110 | 1.2× |
| X-Rays Bone Length Studies (77073) | $236.88 | $1,316 | 1.8× |
| X-Rays Bone Survey Complete (77075) | $674.82 | $3,749 | 5.0× |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$225.36–$333 | $1,252–$1,850 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$160.38–$264.96 | $891–$1,472 | varies |
| Xr orbits complete 4 views (70200) | $301.68 | $1,676 | 2.2× |
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.