Imaging prices at Altru Hospital
Grand Forks, ND · every code in this section with a posted price and a Medicare benchmark.
458 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 4 matching MRF lines |
$392.23–$3,148.82 | $643–$5,162 | varies |
| Abdomen 1 View (74018) range across 4 matching MRF lines |
$41.48–$233.63 | $68–$383 | varies |
| Abdomen 2 views (74019) range across 4 matching MRF lines |
$56.73–$310.49 | $93–$509 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 4 matching MRF lines |
$193.98–$1,313.33 | $318–$2,153 | varies |
| Angio internal mammary (75756) range across 4 matching MRF lines |
$232.41–$2,473.55 | $381–$4,055 | varies |
| Angio pulmonary bilat (75743) range across 4 matching MRF lines |
$411.14–$4,410.30 | $674–$7,230 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) range across 4 matching MRF lines |
$175.68–$4,214.49 | $288–$6,909 | varies |
| Angiography extremity bilateral rs&i (75716) range across 4 matching MRF lines |
$279.38–$4,278.54 | $458–$7,014 | varies |
| Angiography extremity unilateral rs&i (75710) range across 4 matching MRF lines |
$245.83–$3,456.26 | $403–$5,666 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 4 matching MRF lines |
$279.38–$2,520.52 | $458–$4,132 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 4 matching MRF lines |
$153.11–$2,418.04 | $251–$3,964 | varies |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$35.99–$182.39 | $59–$299 | varies |
| Aortography thoracic serialography rs&i (75605) range across 4 matching MRF lines |
$234.24–$4,291.96 | $384–$7,036 | varies |
| Aortography thoracic w/o serialography rs&i (75600) range across 3 matching MRF lines |
$1,911.13–$1,980.67 | $3,133–$3,247 | varies |
| Artery X-Rays Abdomen (75726) range across 4 matching MRF lines |
$212.89–$4,251.70 | $349–$6,970 | varies |
| Artery X-Rays Adrenal Gland (75731) range across 4 matching MRF lines |
$4,038.81–$4,191.92 | $251–$6,872 | varies |
| Artery X-Rays Pelvis (75736) range across 4 matching MRF lines |
$212.89–$4,251.70 | $349–$6,970 | varies |
| Artery X-Rays Spine (75705) range across 4 matching MRF lines |
$381.86–$3,190.91 | $626–$5,231 | varies |
| Arthrogram ankle (73615) range across 4 matching MRF lines |
$63.44–$264.74 | $104–$434 | varies |
| Arthrogram hip (73525) range across 4 matching MRF lines |
$75.03–$453.84 | $123–$744 | varies |
| Arthrogram Wrist (73115) range across 4 matching MRF lines |
$75.64–$356.85 | $124–$585 | varies |
| Basic radiation dosimetry calculation (77300) range across 4 matching MRF lines |
$139.69–$504.47 | $229–$827 | varies |
| Bone age studies (77072) range across 4 matching MRF lines |
$53.68–$165.31 | $88–$271 | varies |
| Bone Imaging 3 Phase (78315) range across 4 matching MRF lines |
$166.53–$1,185.84 | $273–$1,944 | varies |
| Bone Imaging Limited Area (78300) range across 4 matching MRF lines |
$133.59–$771.04 | $219–$1,264 | varies |
| Bone Imaging Multiple Areas (78305) range across 4 matching MRF lines |
$101.87–$916.83 | $167–$1,503 | varies |
| Bone Imaging Whole Body (78306) range across 4 matching MRF lines |
$148.84–$1,049.81 | $244–$1,721 | varies |
| Bone marrow imaging; whole body (78104) range across 4 matching MRF lines |
$97.60–$753.96 | $160–$1,236 | varies |
| Bone survey infant (77076) range across 4 matching MRF lines |
$65.88–$294.02 | $108–$482 | varies |
| Brachytx isodose complex (77318) range across 4 matching MRF lines |
$308.66–$1,410.93 | $506–$2,313 | varies |
| Brachytx isodose intermed (77317) range across 4 matching MRF lines |
$162.26–$1,069.94 | $266–$1,754 | varies |
| Brachytx Isodose Plan Simple (77316) range across 4 matching MRF lines |
$109.19–$854.61 | $179–$1,401 | varies |
| Brain Flow Imaging Only (78610) range across 4 matching MRF lines |
$65.27–$503.25 | $107–$825 | varies |
| Brain Image W/Flow < 4 Views (78601) range across 2 matching MRF lines |
$48.19–$649.65 | $79–$1,065 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 4 matching MRF lines |
$142.13–$778.36 | $233–$1,276 | varies |
| Brain Imaging Minimum 4 Static Views (78605) range across 3 matching MRF lines |
$118.34–$430.05 | $194–$705 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 4 matching MRF lines |
$229.97–$3,900.95 | $377–$6,395 | varies |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $1,353.59 | $2,219 | 2.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 4 matching MRF lines |
$242.17–$1,374.94 | $397–$2,254 | varies |
| Cardiac Shunt Detection (78428) range across 4 matching MRF lines |
$90.28–$622.81 | $148–$1,021 | varies |
| Cat Scan Follow-Up Study (76380) range across 4 matching MRF lines |
$121.39–$574.01 | $199–$941 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 4 matching MRF lines |
$126.88–$929.64 | $208–$1,524 | varies |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) range across 4 matching MRF lines |
$44.53–$484.34 | $73–$794 | varies |
| Cerebrospinal Fluid Scan (78630) range across 4 matching MRF lines |
$135.42–$1,486.57 | $222–$2,437 | varies |
| Chest 1 view (71045) range across 4 matching MRF lines |
$42.09–$186.05 | $69–$305 | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$42.70–$233.63 | $70–$383 | varies |
| Chest 3 views (71047) range across 4 matching MRF lines |
$49.41–$251.32 | $81–$412 | varies |
| Chest 4 or more views (71048) range across 4 matching MRF lines |
$53.07–$268.40 | $87–$440 | varies |
| Cholecystography Oral Contrast (74290) range across 4 matching MRF lines |
$46.97–$403.82 | $77–$662 | varies |
| Cisternography Positive Contrast Rs&I (70015) range across 4 matching MRF lines |
$117.73–$361.12 | $193–$592 | varies |
| Clavicle complete (73000) range across 4 matching MRF lines |
$39.65–$164.70 | $65–$270 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 9 matching MRF lines |
$215.94–$1,449.97 | $354–$2,377 | varies |
| Continuing medical physics consltj pr wk (77336) range across 3 matching MRF lines |
$419.07–$486.17 | $687–$797 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 4 matching MRF lines |
$213.50–$4,305.99 | $350–$7,059 | varies |
| Contrast X-Ray Bladder (74430) range across 4 matching MRF lines |
$59.78–$462.38 | $98–$758 | varies |
| Contrast X-Ray Of Elbow (73085) range across 4 matching MRF lines |
$76.86–$369.05 | $126–$605 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 4 matching MRF lines |
$59.78–$534.97 | $98–$877 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) range across 3 matching MRF lines |
$44.53–$170.19 | $73–$279 | varies |
| Corpora cavernosography (74445) range across 3 matching MRF lines |
$101.87–$206.18 | $167–$338 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 4 matching MRF lines |
$170.19–$3,167.12 | $279–$5,192 | varies |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$148.23–$2,556.51 | $243–$4,191 | varies |
| CT abdomen w contrast (74160) range across 4 matching MRF lines |
$262.91–$1,697.63 | $431–$2,783 | varies |
| CT abdomen w wo contrast (74170) range across 4 matching MRF lines |
$281.21–$2,001.41 | $461–$3,281 | varies |
| CT abdomen w/o contrast (74150) range across 4 matching MRF lines |
$248.88–$1,495.11 | $408–$2,451 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 4 matching MRF lines |
$561.81–$3,623.40 | $921–$5,940 | varies |
| CT Angio Chest (71275) range across 4 matching MRF lines |
$333.67–$2,044.11 | $547–$3,351 | varies |
| CT Angio Head (70496) range across 4 matching MRF lines |
$319.03–$1,900.76 | $523–$3,116 | varies |
| CT angio hrt w/3d image (75574) range across 7 matching MRF lines |
$173.24–$1,399.34 | $284–$2,294 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$333.06–$1,739.11 | $546–$2,851 | varies |
| CT Angio Neck (70498) range across 4 matching MRF lines |
$319.03–$1,948.95 | $523–$3,195 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$204.96–$1,611.01 | $336–$2,641 | varies |
| CT cervical spine w/ contrast (72126) range across 4 matching MRF lines |
$255.59–$1,756.80 | $419–$2,880 | varies |
| CT cervical spine w/o contrast (72125) range across 4 matching MRF lines |
$245.22–$1,745.82 | $402–$2,862 | varies |
| CT cervical spine w/wo cont (72127) range across 4 matching MRF lines |
$160.43–$1,881.85 | $263–$3,085 | varies |
| CT chest w contrast (71260) range across 4 matching MRF lines |
$240.34–$1,641.51 | $394–$2,691 | varies |
| CT chest w/wo contrast (71270) range across 4 matching MRF lines |
$256.20–$1,872.09 | $420–$3,069 | varies |
| CT head/brain with contrast (70460) range across 4 matching MRF lines |
$233.02–$1,437.77 | $382–$2,357 | varies |
| CT head/brain without and with contrast (70470) range across 4 matching MRF lines |
$251.32–$1,831.83 | $412–$3,003 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 4 matching MRF lines |
$150.67–$934.52 | $247–$1,532 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 4 matching MRF lines |
$50.02–$334.89 | $82–$549 | varies |
| CT hrt w/3d image congen (75573) range across 4 matching MRF lines |
$220.21–$1,271.24 | $361–$2,084 | varies |
| CT iac w contrast (70481) range across 4 matching MRF lines |
$284.87–$1,563.43 | $467–$2,563 | varies |
| CT l-spine w&w/o contrast (72133) range across 4 matching MRF lines |
$251.93–$2,172.82 | $413–$3,562 | varies |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$195.20–$1,223.05 | $320–$2,005 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$204.35–$1,360.30 | $335–$2,230 | varies |
| CT lumbar spine w contrast (72132) range across 4 matching MRF lines |
$247.05–$1,592.10 | $405–$2,610 | varies |
| CT lumbar spine w/o contrast (72131) range across 4 matching MRF lines |
$236.07–$1,545.74 | $387–$2,534 | varies |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$266.57–$1,490.23 | $437–$2,443 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$241.56–$1,313.94 | $396–$2,154 | varies |
| CT neck tissue combo (70492) range across 4 matching MRF lines |
$299.51–$2,037.40 | $491–$3,340 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 4 matching MRF lines |
$299.51–$1,740.94 | $491–$2,854 | varies |
| CT orbits w/o contrast (70480) range across 4 matching MRF lines |
$278.16–$1,521.95 | $456–$2,495 | varies |
| CT pelvis w&w/o contrast (72194) range across 4 matching MRF lines |
$211.67–$1,594.54 | $347–$2,614 | varies |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$189.71–$1,354.20 | $311–$2,220 | varies |
| CT scan of leg combo (73702) range across 4 matching MRF lines |
$213.50–$1,815.36 | $350–$2,976 | varies |
| CT scans face/jaw combo (70488) range across 4 matching MRF lines |
$291.58–$1,693.36 | $478–$2,776 | varies |
| CT soft tissue neck w contrast (70491) range across 4 matching MRF lines |
$273.89–$1,709.22 | $449–$2,802 | varies |
| CT soft tissue neck w/o contrast (70490) range across 4 matching MRF lines |
$278.16–$1,520.73 | $456–$2,493 | varies |
| CT thoracic spine w contrast (72129) range across 4 matching MRF lines |
$246.44–$1,600.03 | $404–$2,623 | varies |
| CT thoracic spine w/o contrast (72128) range across 4 matching MRF lines |
$236.07–$1,549.40 | $387–$2,540 | varies |
| CT thoracic spine w/wo cont (72130) range across 4 matching MRF lines |
$153.72–$1,510.36 | $252–$2,476 | varies |
| CT thorax w/o contrast (71250) range across 8 matching MRF lines |
$228.75–$1,448.75 | $375–$2,375 | varies |
| CT unlisted procedure (76497) range across 7 matching MRF lines |
$111.02–$1,850.74 | $182–$3,034 | varies |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$199.47–$1,194.99 | $327–$1,959 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 4 matching MRF lines |
$218.38–$1,493.89 | $358–$2,449 | varies |
| CT upper extremity with contrast (73201) range across 4 matching MRF lines |
$209.84–$1,349.32 | $344–$2,212 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 4 matching MRF lines |
$417.24–$2,421.70 | $684–$3,970 | varies |
| Cta Abdomen (74175) range across 4 matching MRF lines |
$333.67–$1,995.31 | $547–$3,271 | varies |
| CTA pelvis (72191) range across 4 matching MRF lines |
$314.15–$1,975.79 | $515–$3,239 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) range across 3 matching MRF lines |
$43.92–$143.96 | $72–$236 | varies |
| Dilation ureters/urethra rs&i (74485) range across 4 matching MRF lines |
$109.80–$1,074.21 | $180–$1,761 | varies |
| Discography Cerv/Thor Spine (72285) range across 4 matching MRF lines |
$100.04–$1,027.24 | $164–$1,684 | varies |
| Diskography lumbar (72295) range across 4 matching MRF lines |
$103.70–$1,191.33 | $170–$1,953 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 4 matching MRF lines |
$41.48–$95.16 | $68–$156 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$129.32–$168.36 | $212–$276 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 4 matching MRF lines |
$86.01–$405.04 | $141–$664 | varies |
| Dxa Bone Density Axial (77080) range across 5 matching MRF lines |
$39.65–$385.52 | $65–$632 | varies |
| Dxa bone density study (77085) range across 4 matching MRF lines |
$28.67–$592.31 | $47–$971 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 4 matching MRF lines |
$17.69–$132.98 | $29–$218 | varies |
| Echo exam of fetal heart (76825) range across 4 matching MRF lines |
$143.96–$626.47 | $236–$1,027 | varies |
| Echo exam uterus (76831) range across 4 matching MRF lines |
$98.82–$514.23 | $162–$843 | varies |
| Echo Guide For Artery Repair (76936) range across 4 matching MRF lines |
$335.50–$1,448.14 | $550–$2,374 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 4 matching MRF lines |
$78.69–$376.37 | $129–$617 | varies |
| Echograp Trans R Pros Study (76873) range across 4 matching MRF lines |
$162.87–$397.11 | $267–$651 | varies |
| Esophagram (74220) range across 4 matching MRF lines |
$90.89–$382.47 | $149–$627 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 4 matching MRF lines |
$157.38–$386.13 | $258–$633 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$131.15–$437.37 | $215–$717 | varies |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$42.70–$507.52 | $70–$832 | varies |
| Follow-Up Angiography (75898) range across 4 matching MRF lines |
$644.77–$1,412.76 | $1,057–$2,316 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$37.82–$147.62 | $62–$242 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$46.36–$189.10 | $76–$310 | varies |
| Gastric emptying imaging study (78264) range across 4 matching MRF lines |
$164.09–$1,170.59 | $269–$1,919 | varies |
| Gastroesophageal Reflux Exam (78262) range across 4 matching MRF lines |
$81.74–$768.60 | $134–$1,260 | varies |
| Gated Heart Planar Single (78472) range across 4 matching MRF lines |
$176.29–$1,191.33 | $289–$1,953 | varies |
| Gated Heart, Multiple (78473) range across 4 matching MRF lines |
$171.41–$1,525 | $281–$2,500 | varies |
| GI Endoscopic US S&I (76975) range across 3 matching MRF lines |
$86.01–$203.74 | $141–$334 | varies |
| Hand 2 views (73120) range across 4 matching MRF lines |
$34.16–$147.01 | $56–$241 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) range across 4 matching MRF lines |
$567.30–$2,203.93 | $930–$3,613 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 4 matching MRF lines |
$419.68–$1,970.30 | $688–$3,230 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 4 matching MRF lines |
$265.35–$1,643.34 | $435–$2,694 | varies |
| Heart first pass single,planar (78481) range across 4 matching MRF lines |
$197.03–$1,132.77 | $323–$1,857 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 4 matching MRF lines |
$151.89–$2,416.82 | $249–$3,962 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 4 matching MRF lines |
$151.89–$2,416.82 | $249–$3,962 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 4 matching MRF lines |
$187.27–$1,368.84 | $307–$2,244 | varies |
| Hepatobiliary System Imaging (78226) range across 4 matching MRF lines |
$123.83–$1,265.14 | $203–$2,074 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$384.91–$2,089.86 | $631–$3,426 | varies |
| Hysterosalpingogram (74740) range across 4 matching MRF lines |
$51.24–$465.43 | $84–$763 | varies |
| Image fusion (77399) | $649.65 | $1,065 | 4.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 4 matching MRF lines |
$128.10–$475.80 | $210–$780 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 4 matching MRF lines |
$57.95–$232.41 | $95–$381 | varies |
| Infusion Ivp (74410) range across 3 matching MRF lines |
$37.21–$225.70 | $61–$370 | varies |
| Interstitial radiation source applic complex (77778) range across 4 matching MRF lines |
$829.60–$2,758.42 | $1,360–$4,522 | varies |
| Intracavitary Radiation Source Applic Complex (77763) range across 3 matching MRF lines |
$535.58–$1,794.62 | $878–$2,942 | varies |
| Intracavitary Radiation Source Applic Intermed (77762) range across 3 matching MRF lines |
$417.24–$1,052.86 | $684–$1,726 | varies |
| Intracavitary radiation source applic simple (77761) range across 3 matching MRF lines |
$353.80–$784.46 | $580–$1,286 | varies |
| Joint Survey Single View (77077) range across 4 matching MRF lines |
$43.31–$173.85 | $71–$285 | varies |
| K Flow/Funct Image W/Drug (78708) range across 4 matching MRF lines |
$237.90–$1,399.95 | $390–$2,295 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 4 matching MRF lines |
$168.36–$1,240.74 | $276–$2,034 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) range across 4 matching MRF lines |
$124.44–$777.14 | $204–$1,274 | varies |
| Kidney Imaging Morphol (78700) range across 4 matching MRF lines |
$49.41–$733.83 | $81–$1,203 | varies |
| Knee 3 Views (73562) range across 5 matching MRF lines |
$42.09–$162.26 | $69–$266 | varies |
| Leveen/Shunt Patency Exam (78291) range across 3 matching MRF lines |
$99.43–$475.19 | $163–$779 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 4 matching MRF lines |
$152.50–$1,159.61 | $250–$1,901 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) range across 3 matching MRF lines |
$71.37–$270.23 | $117–$443 | varies |
| Liver imaging static only (78201) range across 4 matching MRF lines |
$104.31–$961.97 | $171–$1,577 | varies |
| Liver imaging w/vascular flow (78202) range across 4 matching MRF lines |
$129.32–$944.28 | $212–$1,548 | varies |
| Lung Perf&Ventilat Diferentl (78598) range across 3 matching MRF lines |
$108.58–$883.28 | $178–$1,448 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 4 matching MRF lines |
$309.27–$1,578.07 | $507–$2,587 | varies |
| Lung Ventilation Imaging (78579) range across 3 matching MRF lines |
$54.29–$713.70 | $89–$1,170 | varies |
| Lymph System Imaging (78195) range across 4 matching MRF lines |
$205.57–$1,227.32 | $337–$2,012 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) range across 3 matching MRF lines |
$158.60–$667.34 | $260–$1,094 | varies |
| Lymphangiography extremity only unilateral rs&i (75801) range across 3 matching MRF lines |
$112.85–$622.20 | $185–$1,020 | varies |
| Magnetic Image Jaw Joint (70336) range across 4 matching MRF lines |
$151.89–$1,847.08 | $249–$3,028 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 5 matching MRF lines |
$45.75–$398.33 | $75–$653 | varies |
| Mammary ductogram or galactogram single (77053) range across 5 matching MRF lines |
$40.26–$358.68 | $66–$588 | varies |
| Meckels Divert Exam (78290) range across 4 matching MRF lines |
$161.04–$1,034.56 | $264–$1,696 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 4 matching MRF lines |
$408.70–$1,766.56 | $670–$2,896 | varies |
| Mr safety determination physician/other qhp (76016) range across 3 matching MRF lines |
$39.65–$104.31 | $65–$171 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $15.86 | $26 | 0.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) range across 3 matching MRF lines |
$50.02–$164.09 | $82–$269 | varies |
| Mr safety implt pos&/immoblj (76019) range across 3 matching MRF lines |
$39.65–$213.50 | $65–$350 | varies |
| Mr safety med physics xm customization plng&mntr (76017) range across 3 matching MRF lines |
$50.63–$322.69 | $83–$529 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 4 matching MRF lines |
$236.68–$2,539.43 | $388–$4,163 | varies |
| MRA head w/o contrast (70544) range across 4 matching MRF lines |
$217.16–$1,866.60 | $356–$3,060 | varies |
| MRA head with contrast (70545) range across 4 matching MRF lines |
$255.59–$2,197.22 | $419–$3,602 | varies |
| MRA neck w contrast (70548) range across 4 matching MRF lines |
$138.47–$1,793.40 | $227–$2,940 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 4 matching MRF lines |
$200.69–$2,527.84 | $329–$4,144 | varies |
| MRA neck w/o contrast (70547) range across 4 matching MRF lines |
$137.86–$1,352.37 | $226–$2,217 | varies |
| MRI abdomen w contrast (74182) range across 4 matching MRF lines |
$334.89–$3,178.10 | $549–$5,210 | varies |
| MRI abdomen w/o contrast (74181) range across 4 matching MRF lines |
$291.58–$2,765.13 | $478–$4,533 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$271.45–$2,142.32 | $445–$3,512 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$191.54–$2,427.80 | $314–$3,980 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$278.16–$2,100.23 | $456–$3,443 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$155.55–$703.33 | $255–$1,153 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$141.52–$707.60 | $232–$1,160 | varies |
| MRI cardiac w/o contrast (75557) range across 4 matching MRF lines |
$230.58–$1,127.28 | $378–$1,848 | varies |
| MRI cervical spine w contrast (72142) range across 4 matching MRF lines |
$318.42–$2,532.11 | $522–$4,151 | varies |
| MRI cervical spine w/o cont (72141) range across 4 matching MRF lines |
$278.16–$2,205.15 | $456–$3,615 | varies |
| MRI chest w/o contrast (71550) range across 4 matching MRF lines |
$189.10–$1,811.09 | $310–$2,969 | varies |
| MRI chest with contrast (71551) range across 4 matching MRF lines |
$179.34–$1,595.76 | $294–$2,616 | varies |
| MRI chest wo w contrast (71552) range across 4 matching MRF lines |
$203.13–$2,456.47 | $333–$4,027 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 4 matching MRF lines |
$144.57–$2,083.15 | $237–$3,415 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 4 matching MRF lines |
$261.08–$2,492.46 | $428–$4,086 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$243.39–$1,911.13 | $399–$3,133 | varies |
| MRI lumbar spine w contrast (72149) range across 4 matching MRF lines |
$334.89–$2,867.61 | $549–$4,701 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 4 matching MRF lines |
$292.19–$2,919.46 | $479–$4,786 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 4 matching MRF lines |
$308.66–$1,738.50 | $506–$2,850 | varies |
| MRI orbit face neck w contrast (70542) range across 4 matching MRF lines |
$152.50–$1,787.91 | $250–$2,931 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 4 matching MRF lines |
$201.91–$2,369.24 | $331–$3,884 | varies |
| MRI pelvis w contrast (72196) range across 4 matching MRF lines |
$310.49–$2,519.91 | $509–$4,131 | varies |
| MRI pelvis w/o & w contrast (72197) range across 4 matching MRF lines |
$320.86–$2,623.61 | $526–$4,301 | varies |
| MRI pelvis w/o contrast (72195) range across 4 matching MRF lines |
$288.53–$2,464.40 | $473–$4,040 | varies |
| MRI thoracic spine w/o contrast (72146) range across 4 matching MRF lines |
$287.92–$2,606.53 | $472–$4,273 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 4 matching MRF lines |
$144.57–$1,990.43 | $237–$3,263 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$212.28–$1,924.55 | $348–$3,155 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$218.99–$2,353.38 | $359–$3,858 | varies |
| MRI, abdomen, combo (74183) range across 4 matching MRF lines |
$297.07–$3,708.80 | $487–$6,080 | varies |
| MRI, dorsal spine combo (72157) range across 4 matching MRF lines |
$343.43–$3,514.21 | $563–$5,761 | varies |
| MRI, dorsal spine contrast (72147) range across 4 matching MRF lines |
$373.93–$3,041.46 | $613–$4,986 | varies |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$244.61–$2,077.66 | $401–$3,406 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$246.44–$2,757.20 | $404–$4,520 | varies |
| MRI, lumbar spine combo (72158) range across 4 matching MRF lines |
$303.17–$3,344.63 | $497–$5,483 | varies |
| Myelogram cervical (72240) range across 4 matching MRF lines |
$143.96–$1,625.04 | $236–$2,664 | varies |
| Myelogram Lumbar (72265) range across 4 matching MRF lines |
$147.01–$1,559.16 | $241–$2,556 | varies |
| Myelography thoracic (72255) range across 4 matching MRF lines |
$146.40–$1,285.27 | $240–$2,107 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 4 matching MRF lines |
$178.73–$1,725.69 | $293–$2,829 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) range across 4 matching MRF lines |
$82.35–$663.07 | $135–$1,087 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,136.62 | $5,142 | 2.4× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) range across 3 matching MRF lines |
$96.99–$435.54 | $159–$714 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$444.69–$2,845.65 | $729–$4,665 | varies |
| N-invas est c ffr sw aly CTA (75580) range across 4 matching MRF lines |
$1,252.94–$1,295.64 | $70–$2,124 | varies |
| Neck soft tissue (70360) range across 4 matching MRF lines |
$50.63–$247.05 | $83–$405 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) range across 3 matching MRF lines |
$205.57–$1,061.40 | $337–$1,740 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) range across 2 matching MRF lines |
$344.04–$354.41 | $564–$581 | varies |
| Nm csf leak detection (78650) range across 4 matching MRF lines |
$148.23–$1,020.53 | $243–$1,673 | varies |
| Nm myocard infarct spect (78469) range across 4 matching MRF lines |
$109.80–$950.99 | $180–$1,559 | varies |
| Nonvascular Shunt X-Ray (75809) range across 4 matching MRF lines |
$55.51–$321.47 | $91–$527 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 4 matching MRF lines |
$636.84–$4,082.12 | $1,044–$6,692 | varies |
| Nuclear Rx Intra-Arterial (79445) range across 4 matching MRF lines |
$240.34–$595.97 | $394–$977 | varies |
| Nuclear Rx Oral Admin (79005) range across 4 matching MRF lines |
$215.33–$1,030.90 | $353–$1,690 | varies |
| Ob us nuchal meas 1 gest (76813) range across 4 matching MRF lines |
$131.15–$328.18 | $215–$538 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 10 matching MRF lines |
$54.90–$186.66 | $90–$306 | varies |
| Ophthalmic Biometry US Echograpy a-Scan (76516) range across 3 matching MRF lines |
$17.69–$162.26 | $29–$266 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 5 matching MRF lines |
$38.43–$226.92 | $63–$372 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 5 matching MRF lines |
$11.59–$35.38 | $19–$58 | varies |
| Optic foramina (70190) range across 3 matching MRF lines |
$29.28–$107.97 | $48–$177 | varies |
| Panoramic X-ray of jaws (70355) range across 4 matching MRF lines |
$40.87–$152.50 | $67–$250 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 4 matching MRF lines |
$137.25–$887.55 | $225–$1,455 | varies |
| Parathyroid Planar Imaging (78070) range across 4 matching MRF lines |
$102.48–$980.27 | $168–$1,607 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) | $116.51 | $191 | 0.3× |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$42.09–$173.85 | $69–$285 | varies |
| Perineogram (74775) range across 4 matching MRF lines |
$65.27–$335.50 | $107–$550 | varies |
| Peritoneogram Rs&I (74190) range across 4 matching MRF lines |
$71.37–$455.67 | $117–$747 | varies |
| Pet Image Skull-Thigh (78812) range across 4 matching MRF lines |
$230.58–$3,929.01 | $378–$6,441 | varies |
| Pet Image W/Ct Lmtd (78814) range across 4 matching MRF lines |
$242.78–$3,940.60 | $398–$6,460 | varies |
| PET image w/CT, full body (78816) range across 4 matching MRF lines |
$264.74–$4,504.24 | $434–$7,384 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 4 matching MRF lines |
$242.17–$4,190.70 | $397–$6,870 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) range across 4 matching MRF lines |
$229.97–$4,446.90 | $377–$7,290 | varies |
| PET whole body (78813) range across 4 matching MRF lines |
$230.58–$3,929.01 | $378–$6,441 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 4 matching MRF lines |
$292.80–$2,559.56 | $480–$4,196 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 4 matching MRF lines |
$154.33–$957.09 | $253–$1,569 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 4 matching MRF lines |
$46.36–$358.07 | $76–$587 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 4 matching MRF lines |
$84.18–$619.15 | $138–$1,015 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$37.82–$191.54 | $62–$314 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$33.55–$176.29 | $55–$289 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$38.43–$186.66 | $63–$306 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 4 matching MRF lines |
$58.56–$253.76 | $96–$416 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$26.23–$125.05 | $43–$205 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$37.82–$184.22 | $62–$302 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$34.77–$188.49 | $57–$309 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$40.26–$129.32 | $66–$212 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 4 matching MRF lines |
$65.27–$165.31 | $107–$271 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 4 matching MRF lines |
$33.55–$199.47 | $55–$327 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) range across 3 matching MRF lines |
$46.97–$162.87 | $77–$267 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$48.19–$173.24 | $79–$284 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$43.92–$225.70 | $72–$370 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 4 matching MRF lines |
$33.55–$147.01 | $55–$241 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 4 matching MRF lines |
$72.59–$584.38 | $119–$958 | varies |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$36.60–$137.25 | $60–$225 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 4 matching MRF lines |
$40.26–$206.18 | $66–$338 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 4 matching MRF lines |
$68.32–$231.19 | $112–$379 | varies |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$29.89–$143.96 | $49–$236 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 4 matching MRF lines |
$38.43–$124.44 | $63–$204 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$35.99–$182.39 | $59–$299 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 3 matching MRF lines |
$29.89–$154.33 | $49–$253 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $3,825.31 | $6,271 | 0.5× |
| Radiation treatment delivery level 1 (77402) | $427 | $700 | 4.1× |
| Radiation treatment delivery level 2 (77407) | $590.48 | $968 | 1.5× |
| Radiation treatment delivery level 3 (77412) | $620.37 | $1,017 | 1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 4 matching MRF lines |
$24.40–$125.05 | $40–$205 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 4 matching MRF lines |
$62.83–$391.01 | $103–$641 | varies |
| Radiologic exam colon double contrast study (74280) range across 4 matching MRF lines |
$128.10–$875.96 | $210–$1,436 | varies |
| Radiologic exam colon single contrast study (74270) range across 4 matching MRF lines |
$145.18–$803.98 | $238–$1,318 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 4 matching MRF lines |
$75.64–$367.22 | $124–$602 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$48.19–$242.17 | $79–$397 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 4 matching MRF lines |
$51.24–$244 | $84–$400 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 4 matching MRF lines |
$95.16–$571.57 | $156–$937 | varies |
| Radiologic exam swallow function contrast study (74230) range across 4 matching MRF lines |
$90.89–$757.62 | $149–$1,242 | varies |
| Radiologic exam teeth complete full mouth (70320) range across 3 matching MRF lines |
$30.50–$135.42 | $50–$222 | varies |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) range across 3 matching MRF lines |
$21.96–$58.56 | $36–$96 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 4 matching MRF lines |
$138.47–$774.09 | $227–$1,269 | varies |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$36.60–$193.98 | $60–$318 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$40.87–$206.18 | $67–$338 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$37.82–$173.85 | $62–$285 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 4 matching MRF lines |
$57.95–$256.20 | $95–$420 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) range across 4 matching MRF lines |
$25.01–$115.90 | $41–$190 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$39.65–$209.23 | $65–$343 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) range across 3 matching MRF lines |
$43.92–$192.76 | $72–$316 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) range across 3 matching MRF lines |
$16.47–$39.04 | $27–$64 | varies |
| Red Cell Volume Determination Spx 1 Sampling (78120) range across 3 matching MRF lines |
$26.84–$167.75 | $44–$275 | varies |
| Red Cell Volume Determination Spx Mult Samplings (78121) range across 4 matching MRF lines |
$68.93–$458.72 | $113–$752 | varies |
| Renal Cyst Study (74470) range across 3 matching MRF lines |
$72.59–$189.71 | $119–$311 | varies |
| Ribs bilateral 3 views (71110) range across 4 matching MRF lines |
$55.51–$222.04 | $91–$364 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 4 matching MRF lines |
$78.69–$586.21 | $129–$961 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 4 matching MRF lines |
$94.55–$738.10 | $155–$1,210 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 4 matching MRF lines |
$186.05–$1,622.60 | $305–$2,660 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 4 matching MRF lines |
$153.72–$1,252.94 | $252–$2,054 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines |
$168.97–$1,404.22 | $277–$2,302 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) range across 4 matching MRF lines |
$172.63–$1,620.16 | $283–$2,656 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 4 matching MRF lines |
$200.69–$2,112.43 | $329–$3,463 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 4 matching MRF lines |
$140.91–$1,116.30 | $231–$1,830 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) range across 4 matching MRF lines |
$284.26–$678.93 | $466–$1,113 | varies |
| Rp Therapy Intravenous Administration (79101) range across 4 matching MRF lines |
$224.48–$890.60 | $368–$1,460 | varies |
| Salivary Gland Imaging Serial Images (78231) range across 4 matching MRF lines |
$63.44–$548.39 | $104–$899 | varies |
| Scapula (73010) range across 4 matching MRF lines |
$42.70–$184.22 | $70–$302 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 4 matching MRF lines |
$51.24–$115.90 | $84–$190 | varies |
| Sella turcica (70240) range across 3 matching MRF lines |
$25.01–$110.41 | $41–$181 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$37.82–$167.14 | $62–$274 | varies |
| Shoulder Arthrography (73040) range across 4 matching MRF lines |
$112.85–$675.88 | $185–$1,108 | varies |
| Sialogram (70390) range across 5 matching MRF lines |
$50.02–$287.92 | $82–$472 | varies |
| Skull less than 4 views (70250) range across 4 matching MRF lines |
$46.97–$213.50 | $77–$350 | varies |
| Special dosimetry (77331) range across 4 matching MRF lines |
$120.17–$287.31 | $197–$471 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$582.55–$649.65 | $955–$1,065 | varies |
| Special teletherapy port plan (77321) range across 4 matching MRF lines |
$304.39–$1,446.31 | $499–$2,371 | varies |
| Special treatment procedure (77470) range across 4 matching MRF lines |
$242.78–$1,873.92 | $398–$3,072 | varies |
| Speech evaluation, complex (70371) range across 4 matching MRF lines |
$181.17–$1,082.14 | $297–$1,774 | varies |
| Spleen Imaging (78185) range across 3 matching MRF lines |
$88.45–$411.75 | $145–$675 | varies |
| Stereotactic Body Radiation Delivery (77373) | $4,969.67 | $8,147 | 2.7× |
| Sternoclavicular joints (71130) range across 4 matching MRF lines |
$46.36–$164.09 | $76–$269 | varies |
| Superior sagittal sinus venogram (75870) range across 3 matching MRF lines |
$150.67–$529.48 | $247–$868 | varies |
| Surface Applic Low Dose Rate Radionuclide Source (77789) range across 3 matching MRF lines |
$109.19–$234.85 | $179–$385 | varies |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) range across 2 matching MRF lines |
$19.52–$113.46 | $32–$186 | varies |
| Tbs technical calculation only (77091) | $113.46 | $186 | 1.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 4 matching MRF lines |
$247.05–$1,240.13 | $405–$2,033 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 4 matching MRF lines |
$122–$981.49 | $200–$1,609 | varies |
| Temporomandble Jt Arthrography Rs&I (70332) range across 3 matching MRF lines |
$68.93–$239.73 | $113–$393 | varies |
| Testicular Imaging W/Flow (78761) range across 4 matching MRF lines |
$84.79–$728.95 | $139–$1,195 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 4 matching MRF lines |
$409.92–$2,347.28 | $672–$3,848 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 4 matching MRF lines |
$269.62–$1,784.86 | $442–$2,926 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 4 matching MRF lines |
$193.37–$1,227.32 | $317–$2,012 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 4 matching MRF lines |
$208.62–$588.65 | $342–$965 | varies |
| Thoracic spine 2 views (72070) range across 4 matching MRF lines |
$45.75–$242.78 | $75–$398 | varies |
| Thoracic spine 3 views (72072) range across 4 matching MRF lines |
$46.36–$249.49 | $76–$409 | varies |
| Thoracolumbar 2 views (72080) range across 4 matching MRF lines |
$48.80–$255.59 | $80–$419 | varies |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) range across 3 matching MRF lines |
$101.26–$602.68 | $166–$988 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) range across 4 matching MRF lines |
$106.14–$846.68 | $174–$1,388 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 4 matching MRF lines |
$48.19–$517.89 | $79–$849 | varies |
| Thyroid Met Imaging Body (78018) range across 4 matching MRF lines |
$165.92–$1,361.52 | $272–$2,232 | varies |
| Thyroid Uptake Measurement (78012) range across 4 matching MRF lines |
$36.60–$333.67 | $60–$547 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 4 matching MRF lines |
$106.14–$846.68 | $174–$1,388 | varies |
| Tx Devices Design & Construction Complex (77334) range across 4 matching MRF lines |
$260.47–$1,024.80 | $427–$1,680 | varies |
| Tx devices design & construction intermediate (77333) range across 4 matching MRF lines |
$147.01–$614.27 | $241–$1,007 | varies |
| Tx devices design & construction simple (77332) range across 4 matching MRF lines |
$115.90–$475.19 | $190–$779 | varies |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$97.60–$348.92 | $160–$572 | varies |
| Ultrasound elastography first target lesion (76982) range across 4 matching MRF lines |
$39.65–$132.98 | $65–$218 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 4 matching MRF lines |
$57.95–$252.54 | $95–$414 | varies |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$99.43–$483.12 | $163–$792 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 4 matching MRF lines |
$90.28–$334.28 | $148–$548 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $1,062.01 | $1,741 | 11.9× |
| Unlisted fluoroscopic procedure (76496) range across 4 matching MRF lines |
$123.83–$663.07 | $203–$1,087 | varies |
| Unlisted us procedure (76999) | $131.76 | $216 | 1.5× |
| Upper gi w/o kub (74240) range across 4 matching MRF lines |
$137.25–$810.69 | $225–$1,329 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) range across 2 matching MRF lines |
$254.98–$262.30 | $418–$430 | varies |
| Ureteral Reflux Study (78740) range across 4 matching MRF lines |
$119.56–$638.06 | $196–$1,046 | varies |
| Urethrocystogram voiding (74455) range across 4 matching MRF lines |
$71.37–$425.78 | $117–$698 | varies |
| Urethrocystography retrograde (74450) range across 4 matching MRF lines |
$67.71–$488 | $111–$800 | varies |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$99.43–$350.75 | $163–$575 | varies |
| Us chest (76604) range across 4 matching MRF lines |
$51.24–$284.26 | $84–$466 | varies |
| Us complete joint (76881) range across 4 matching MRF lines |
$107.97–$497.76 | $177–$816 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$97.60–$350.75 | $160–$575 | varies |
| Us head (76506) range across 4 matching MRF lines |
$109.19–$576.45 | $179–$945 | varies |
| Us kidney transplant (76776) range across 4 matching MRF lines |
$64.05–$359.90 | $105–$590 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$98.82–$434.32 | $162–$712 | varies |
| Us ob detailed single fetus (76811) range across 4 matching MRF lines |
$162.26–$452.01 | $266–$741 | varies |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$91.50–$288.53 | $150–$473 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$138.47–$473.97 | $227–$777 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$120.17–$449.57 | $197–$737 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 4 matching MRF lines |
$91.50–$325.74 | $150–$534 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 4 matching MRF lines |
$86.01–$281.21 | $141–$461 | varies |
| Us retroperitoneal complete (76770) range across 4 matching MRF lines |
$118.34–$506.91 | $194–$831 | varies |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$79.91–$403.21 | $131–$661 | varies |
| Us scrotum and contents (76870) range across 4 matching MRF lines |
$99.43–$389.18 | $163–$638 | varies |
| Us spinal canal and contents (76800) range across 4 matching MRF lines |
$123.22–$639.89 | $202–$1,049 | varies |
| Us thyroid (76536) range across 4 matching MRF lines |
$91.50–$447.13 | $150–$733 | varies |
| Us transrectal (76872) range across 4 matching MRF lines |
$147.01–$422.12 | $241–$692 | varies |
| Vascular Flow Imaging (78445) range across 4 matching MRF lines |
$181.78–$742.37 | $298–$1,217 | varies |
| Vasogram (74440) range across 4 matching MRF lines |
$29.89–$359.90 | $49–$590 | varies |
| Vein X-Ray Chest (75827) range across 4 matching MRF lines |
$190.93–$2,863.34 | $313–$4,694 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) range across 4 matching MRF lines |
$239.73–$4,278.54 | $393–$7,014 | varies |
| Vein X-Ray Spleen/Liver (75810) range across 4 matching MRF lines |
$2,309.46–$2,430.24 | $198–$3,984 | varies |
| Venogram Sinus/Jugular (75860) range across 4 matching MRF lines |
$150.67–$1,990.43 | $247–$3,263 | varies |
| Venography Adrenal Unilateral (75840) range across 3 matching MRF lines |
$153.72–$520.94 | $252–$854 | varies |
| Venography caval inferior serialography rs&i (75825) range across 4 matching MRF lines |
$190.32–$3,327.55 | $312–$5,455 | varies |
| Venography extremity bilateral rs&i (75822) range across 4 matching MRF lines |
$306.83–$1,690.92 | $503–$2,772 | varies |
| Venography extremity unilateral rs&i (75820) range across 4 matching MRF lines |
$211.06–$1,767.78 | $346–$2,898 | varies |
| Venography Renal Bilateral (75833) range across 4 matching MRF lines |
$279.99–$2,671.80 | $459–$4,380 | varies |
| Venography Renal Unilateral (75831) range across 4 matching MRF lines |
$187.88–$2,835.89 | $308–$4,649 | varies |
| Venous sampling by catheter (75893) range across 3 matching MRF lines |
$2,266.76–$2,341.18 | $3,716–$3,838 | varies |
| Venous thrombosis imaging (78457) range across 4 matching MRF lines |
$92.11–$560.59 | $151–$919 | varies |
| Venous Thrombosis Imaging Venogram Bilateral (78458) range across 4 matching MRF lines |
$107.97–$770.43 | $177–$1,263 | varies |
| Vertebral fracture assessment via dxa (77086) range across 4 matching MRF lines |
$24.40–$103.70 | $40–$170 | varies |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$34.77–$142.74 | $57–$234 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 4 matching MRF lines |
$40.87–$173.85 | $67–$285 | varies |
| X-ray antegrade pyelogram tube (74425) range across 4 matching MRF lines |
$74.42–$638.06 | $122–$1,046 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 4 matching MRF lines |
$344.65–$3,109.17 | $565–$5,097 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 5 matching MRF lines |
$29.28–$211.67 | $48–$347 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$46.36–$157.38 | $76–$258 | varies |
| X-Ray Exam Breast Specimen (76098) range across 4 matching MRF lines |
$20.13–$138.47 | $33–$227 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 4 matching MRF lines |
$58.56–$367.83 | $96–$603 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 4 matching MRF lines |
$65.27–$381.86 | $107–$626 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 4 matching MRF lines |
$74.42–$397.72 | $122–$652 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$70.15–$445.30 | $115–$730 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$78.08–$475.80 | $128–$780 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 4 matching MRF lines |
$84.79–$490.44 | $139–$804 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 4 matching MRF lines |
$56.73–$319.03 | $93–$523 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 4 matching MRF lines |
$57.95–$325.13 | $95–$533 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 4 matching MRF lines |
$65.27–$335.50 | $107–$550 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 4 matching MRF lines |
$46.97–$322.69 | $77–$529 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$50.02–$182.39 | $82–$299 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 4 matching MRF lines |
$68.93–$378.81 | $113–$621 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 4 matching MRF lines |
$59.78–$275.11 | $98–$451 | varies |
| X-ray eye for foreign body (70030) range across 5 matching MRF lines |
$24.40–$81.13 | $40–$133 | varies |
| X-ray head for orthodontia (70350) range across 3 matching MRF lines |
$20.74–$60.39 | $34–$99 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$38.43–$178.73 | $63–$293 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 4 matching MRF lines |
$95.16–$597.19 | $156–$979 | varies |
| X-ray IV pyelogram+tomography (74415) range across 4 matching MRF lines |
$95.16–$841.80 | $156–$1,380 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 4 matching MRF lines |
$30.50–$95.77 | $50–$157 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 4 matching MRF lines |
$40.26–$166.53 | $66–$273 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 4 matching MRF lines |
$44.53–$250.71 | $73–$411 | varies |
| X-ray nose-rectum child f.b. (76010) range across 4 matching MRF lines |
$43.92–$179.95 | $72–$295 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 4 matching MRF lines |
$40.87–$287.31 | $67–$471 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 4 matching MRF lines |
$68.32–$204.35 | $112–$335 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 4 matching MRF lines |
$43.92–$147.62 | $72–$242 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 4 matching MRF lines |
$42.70–$187.88 | $70–$308 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 4 matching MRF lines |
$56.73–$259.25 | $93–$425 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 4 matching MRF lines |
$64.66–$363.56 | $106–$596 | varies |
| X-Ray Stress View (77071) range across 3 matching MRF lines |
$62.83–$152.50 | $103–$250 | varies |
| X-ray thoracic spine 4 vw (72074) range across 4 matching MRF lines |
$26.23–$242.78 | $43–$398 | varies |
| X-Ray Tmj Unilat (70328) range across 3 matching MRF lines |
$29.89–$70.15 | $49–$115 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 4 matching MRF lines |
$40.87–$612.44 | $67–$1,004 | varies |
| X-Rays Bone Length Studies (77073) range across 4 matching MRF lines |
$59.78–$189.10 | $98–$310 | varies |
| X-Rays Bone Survey Complete (77075) range across 4 matching MRF lines |
$108.58–$501.42 | $178–$822 | varies |
| Xr c-spine 4 or 5 views (72050) range across 4 matching MRF lines |
$62.83–$258.03 | $103–$423 | varies |
| Xr facial bones less than 3 views (70140) range across 4 matching MRF lines |
$29.89–$96.99 | $49–$159 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 3 matching MRF lines |
$24.40–$91.50 | $40–$150 | varies |
| Xr myelogram posterior fossa (70010) range across 3 matching MRF lines |
$156.16–$373.32 | $256–$612 | varies |
| Xr orbits complete 4 views (70200) range across 4 matching MRF lines |
$51.85–$238.51 | $85–$391 | varies |
| Xr Tomogram Single Plane (76100) range across 4 matching MRF lines |
$81.13–$281.82 | $133–$462 | 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.