Imaging prices at Altus Houston Hospital, Lp

Houston, TX · every code in this section with a posted price and a Medicare benchmark.

452 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $5,049 $5,049 3.6×
Abdomen 1 View (74018) $995 $995 11.4×
Abdomen 2 views (74019) $730 $730 7.0×
Acute Gastrointestinal Blood Loss Imaging (78278) $7,069 $7,069 17.6×
Acute venous thrombosis imaging, peptide Non-Facility (78456) $3,517 $3,517 2.7×
Adrenal Cortex & Medulla Img (78075) $6,419 $6,419 4.9×
Angio internal mammary (75756) $17,585 $17,585 5.5×
Angio pulmonary bilat (75743) $54,409 $54,409 17.2×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $54,409 $54,409 17.2×
Angiography extremity bilateral rs&i (75716) $19,648 $19,648 6.2×
Angiography extremity unilateral rs&i (75710) $23,495 $23,495 7.4×
Angiography pulmonary unilateral slctv rs&i (75741) $54,409 $54,409 17.2×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $17,585 $17,585 5.5×
Ankle 2 views (73600)
range across 2 matching MRF lines		 $661–$669 $661–$669 varies
Aortography thoracic serialography rs&i (75605) $31,690 $31,690 5.7×
Aortography thoracic w/o serialography rs&i (75600) $54,409 $54,409 17.2×
Artery X-Rays Abdomen (75726) $32,262 $32,262 5.8×
Artery X-Rays Adrenal Gland (75731) $54,409 $54,409 17.2×
Artery X-Rays Pelvis (75736) $18,426 $18,426 3.3×
Artery X-Rays Spine (75705) $28,941 $28,941 5.2×
Basic radiation dosimetry calculation (77300) $646 $646 4.8×
Bone age studies (77072) $2,495 $2,495 23.8×
Bone Imaging 3 Phase (78315) $3,940 $3,940 9.8×
Bone Imaging Limited Area (78300) $7,069 $7,069 17.6×
Bone Imaging Multiple Areas (78305) $7,069 $7,069 17.6×
Bone Imaging Whole Body (78306) $3,235 $3,235 8.1×
Bone marrow imaging limited area (78102) $2,459 $2,459 6.1×
Bone marrow imaging; multiple areas (78103) $2,794 $2,794 7.0×
Bone marrow imaging; whole body (78104) $3,746 $3,746 9.3×
Bone survey infant (77076) $2,019 $2,019 19.2×
Brain Flow Imaging Only (78610) $2,988 $2,988 5.5×
Brain Image W/Flow < 4 Views (78601) $4,447 $4,447 11.1×
Brain imaging < 4 static views (78600) $2,988 $2,988 7.4×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $4,447 $4,447 8.2×
Brain Imaging Minimum 4 Static Views (78605) $5,307 $5,307 9.7×
Brain Imaging Pet Metabolic Evaluation (78608) $15,671 $15,671 10.9×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $3,469 $3,469 8.6×
Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) $5,356 $5,356 9.8×
Cardiac MRI w/w/o contrast & further seq (75561) $10,265 $10,265 29.3×
Cardiac MRI w/w/o contrast w/stress (75563) $24,236 $24,236 30.8×
Cardiac Shunt Detection (78428) $3,311 $3,311 8.2×
Cat Scan Follow-Up Study (76380) $2,227 $2,227 25.5×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $3,640 $3,640 6.7×
Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) $4,447 $4,447 8.2×
Cerebrospinal Fluid Scan (78630) $4,765 $4,765 8.7×
Chest 1 view (71045) $660 $660 7.5×
Chest 2 views (71046) $839 $839 9.6×
Chest 3 views (71047) $841 $841 9.6×
Chest 4 or more views (71048) $831 $831 7.9×
Cholecystography Oral Contrast (74290) $2,161 $2,161 12.3×
Cineradiograpy/vidradiograpy xcpt where spec (76120) $3,390 $3,390 32.3×
Cisternography Positive Contrast Rs&I (70015) $13,053 $13,053 16.6×
Clavicle complete (73000) $374 $374 4.3×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $5,501 $5,501 52.4×
Continuing medical physics consltj pr wk (77336) $667 $667 4.9×
Contrast Exam Abdominl Aorta (75625) $7,812 $7,812 2.5×
Contrast X-Ray Bladder (74430) $5,637 $5,637 16.1×
Contrast Xray Throat/Cerv Esopha (74210) $2,161 $2,161 12.3×
Corpora cavernosography (74445)
range across 2 matching MRF lines		 $415–$5,637 $415–$5,637 varies
CT abdomen and pelvis without and with contrast (74178) $12,555 $12,555 35.8×
CT abdomen and pelvis without contrast (74176) $10,697 $10,697 44.6×
CT abdomen w contrast (74160) $6,581 $6,581 37.3×
CT abdomen w wo contrast (74170) $7,262 $7,262 41.2×
CT abdomen w/o contrast (74150) $5,966 $5,966 56.8×
CT Angio Abdomen and Pelvis (74174) $10,369 $10,369 29.6×
CT Angio Chest (71275) $6,080 $6,080 34.5×
CT Angio Head (70496) $7,000 $7,000 39.7×
Ct Angio Lwr Extr W/O&W/Dye (73706) $5,991 $5,991 34.0×
CT Angio Neck (70498) $7,010 $7,010 39.8×
Ct Angio Upr Extrm W/O&W/Dye (73206) $7,115 $7,115 40.4×
CT bone density (77078) $1,262 $1,262 14.4×
CT cervical spine w/ contrast (72126) $5,862 $5,862 16.7×
CT cervical spine w/o contrast (72125) $8,000 $8,000 76.2×
CT cervical spine w/wo cont (72127) $6,824 $6,824 38.7×
CT chest w contrast (71260) $6,090 $6,090 34.6×
CT chest w/wo contrast (71270) $6,209 $6,209 35.2×
CT head/brain with contrast (70460) $5,120 $5,120 29.1×
CT head/brain without and with contrast (70470) $6,101 $6,101 34.6×
CT iac w contrast (70481) $5,120 $5,120 29.1×
CT l-spine w&w/o contrast (72133) $7,366 $7,366 41.8×
CT lower ext w/o (73700) $4,309 $4,309 41.0×
CT lower extremity w/contrast material (73701) $5,120 $5,120 29.1×
CT lumbar spine w contrast (72132) $5,947 $5,947 17.0×
CT lumbar spine w/o contrast (72131) $6,490 $6,490 61.8×
CT maxillofacial w contrast (70487) $5,120 $5,120 29.1×
CT maxillofacial wo contrast (70486) $4,886 $4,886 46.5×
CT neck tissue combo (70492) $6,650 $6,650 37.7×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $6,502 $6,502 36.9×
CT orbits w/o contrast (70480) $4,777 $4,777 45.5×
CT pelvis w&w/o contrast (72194) $6,484 $6,484 36.8×
CT pelvis w/o contrast (72192) $4,702 $4,702 44.8×
CT scan of leg combo (73702) $6,408 $6,408 36.4×
CT scans face/jaw combo (70488) $6,250 $6,250 35.5×
CT soft tissue neck w contrast (70491) $5,120 $5,120 29.1×
CT soft tissue neck w/o contrast (70490) $5,140 $5,140 48.9×
CT thoracic spine w contrast (72129) $5,910 $5,910 33.5×
CT thoracic spine w/o contrast (72128) $6,343 $6,343 60.4×
CT thoracic spine w/wo cont (72130) $6,659 $6,659 37.8×
CT thorax w/o contrast (71250) $4,594 $4,594 43.7×
CT unlisted procedure (76497) $1,262 $1,262 14.4×
CT upper ext wo (73200) $3,344 $3,344 31.8×
CT upper extremity w/o & w/contrast material (73202) $6,044 $6,044 34.3×
CT upper extremity with contrast (73201) $5,120 $5,120 14.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $7,069 $7,069 40.1×
Cta Abdomen (74175) $6,043 $6,043 34.3×
CTA pelvis (72191) $5,991 $5,991 34.0×
Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) $7,162 $7,162 29.9×
Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) $1,975 $1,975 3.6×
Dilation ureters/urethra rs&i (74485) $26,073 $26,073 12.4×
Discography Cerv/Thor Spine (72285) $7,212 $7,212 3.7×
Diskography lumbar (72295) $7,212 $7,212 3.7×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $1,589 $1,589 15.1×
Doppler Echo Fetal Spectral Display Complete (76827) $1,948 $1,948 18.5×
Doppler Fetal Mid Cerebral Artery (76821) $1,948 $1,948 18.5×
Dxa Bone Density Axial (77080) $2,019 $2,019 19.2×
Dxa bone density study 1/>sites appendiclr skel (77081) $1,262 $1,262 14.4×
Echo exam of fetal heart (76825) $8,983 $8,983 16.4×
Echo exam uterus (76831) $2,481 $2,481 10.4×
Echo Guide For Artery Repair (76936) $7,008 $7,008 32.3×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $7,099 $7,099 29.6×
Echograp Trans R Pros Study (76873) $4,029 $4,029 38.4×
Esophageal Motility Study (78258) $2,215 $2,215 5.5×
Esophagram (74220) $2,161 $2,161 12.3×
Fetal Biophys Profile W/Nst (76818) $2,866 $2,866 27.3×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $2,866 $2,866 27.3×
Fluoroscopy up to 1 hr (76000) $1,201 $1,201 5.0×
Follow-Up Angiography (75898) $6,484 $6,484 2.0×
Foot 2 views (73620) $657 $657 7.5×
Forearm 2 views (73090) $661 $661 7.6×
Gastric emptying imaging study (78264) $2,836 $2,836 7.1×
Gastric Mucosa Imaging (78261) $2,928 $2,928 7.3×
Gastroesophageal Reflux Exam (78262) $3,971 $3,971 9.9×
Gastrointestinal Protein Loss (78282) $2,928 $2,928 7.3×
Gated Heart Planar Single (78472) $7,069 $7,069 17.6×
Gated Heart, Multiple (78473) $5,812 $5,812 14.5×
GI Endoscopic US S&I (76975) $4,029 $4,029 16.8×
Heart first pass single,planar (78481) $4,662 $4,662 8.5×
Heart Image (Pet) Multiple (78492) $13,726 $13,726 9.6×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $36,915 $36,915 11.6×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $44,270 $44,270 14.0×
Hepatobil Syst Image W/Drug (78227) $7,069 $7,069 13.0×
Hepatobiliary System Imaging (78226) $7,069 $7,069 17.6×
High energy neutron radj tx dlvr 1/> isocenter (77423) $6,136 $6,136 11.1×
Hyperthermia external generated superficial (77600) $4,252 $4,252 11.0×
Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) $3,976 $3,976 7.2×
Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) $3,976 $3,976 7.2×
Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) $3,976 $3,976 7.2×
Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) $3,976 $3,976 5.7×
Hysterosalpingogram (74740) $7,162 $7,162 29.9×
Infant hip ultrasound with hip movement (dynamic) (76885) $1,948 $1,948 22.3×
Infant hip ultrasound, limited static exam (76886) $1,948 $1,948 22.3×
Infusion Ivp (74410) $5,637 $5,637 32.0×
Interstitial radiation source applic complex (77778) $9,657 $9,657 13.8×
Intracavitary Radiation Source Applic Complex (77763) $6,190 $6,190 8.8×
Intracavitary Radiation Source Applic Intermed (77762) $4,110 $4,110 7.4×
Intracavitary radiation source applic simple (77761) $4,842 $4,842 8.7×
Intraop radiaj tx deliver xray single tx session (77424) $14,591 $14,591 2.0×
Joint Survey Single View (77077) $2,019 $2,019 19.2×
K Flow/Funct Image Multiple (78709) $5,399 $5,399 9.9×
K Flow/Funct Image W/Drug (78708) $4,019 $4,019 7.4×
K Flow/Funct Image W/O Drug (78707) $1,861 $1,861 3.4×
Kidney Funcj Study Non-Img Radioisotopic Study (78725) $2,686 $2,686 6.7×
Kidney Imaging Morphol (78700) $3,723 $3,723 9.3×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $4,009 $4,009 10.0×
Knee 3 Views (73562) $1,262 $1,262 14.4×
Labeled RBC Sequestration Differntl Organ/Tissue (78140) $4,287 $4,287 10.7×
Leveen/Shunt Patency Exam (78291) $3,158 $3,158 7.9×
Liver & Spleen Imaging Static Only (78215) $3,764 $3,764 9.4×
Liver & Spleen Imaging W/Vascular Flow (78216) $3,785 $3,785 9.4×
Liver imaging static only (78201) $3,248 $3,248 6.0×
Liver imaging w/vascular flow (78202) $3,252 $3,252 6.0×
Lymph System Imaging (78195) $7,069 $7,069 13.0×
Lymphangiography Extremity Only Bilateral Rs&I (75803) $17,281 $17,281 10.9×
Lymphangiography extremity only unilateral rs&i (75801) $7,162 $7,162 11.4×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $17,281 $17,281 5.4×
Lymphangiography, pelvic/abdominal, unilateral (75805) $17,281 $17,281 5.4×
Magnetic Image Jaw Joint (70336) $6,536 $6,536 27.3×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) $9,075 $9,075 51.5×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) $6,086 $6,086 11.1×
Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) $10,265 $10,265 58.3×
Mammary ductogram or galactogram multiple (77054) $7,162 $7,162 29.9×
Mammary ductogram or galactogram single (77053) $7,162 $7,162 29.9×
Meckels Divert Exam (78290) $7,069 $7,069 17.6×
Mra Head W/O & W/Contrast Material (70546) $10,265 $10,265 29.3×
MRA head w/o contrast (70544) $6,383 $6,383 26.6×
MRA head with contrast (70545) $9,075 $9,075 25.9×
MRA neck w contrast (70548) $9,075 $9,075 25.9×
Mra Neck W/O &W/Contrast Material (70549) $10,265 $10,265 29.3×
MRA neck w/o contrast (70547) $6,367 $6,367 26.6×
MRI abdomen w contrast (74182) $9,075 $9,075 25.9×
MRI abdomen w/o contrast (74181) $6,668 $6,668 27.8×
MRI any jt lower extrem w/contrast material (73722) $9,075 $9,075 11.5×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $10,265 $10,265 29.3×
MRI any jt upper extremity w/contrast matrl (73222) $9,075 $9,075 11.5×
MRI bone marrow blood supply (77084) $5,213 $5,213 21.7×
MRI brain functional w/o physician admnistration (70554) $7,091 $7,091 29.6×
MRI brain functional w/physician admnistration (70555) $7,549 $7,549 31.5×
MRI cardiac w/o cont stress (75559) $6,604 $6,604 12.0×
MRI cardiac w/o contrast (75557) $6,086 $6,086 25.4×
MRI cervical spine w contrast (72142) $9,075 $9,075 25.9×
MRI cervical spine w/o cont (72141) $8,786 $8,786 36.7×
MRI chest w/o contrast (71550) $6,086 $6,086 25.4×
MRI chest with contrast (71551) $9,075 $9,075 11.5×
MRI chest wo w contrast (71552) $10,383 $10,383 29.6×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $7,490 $7,490 21.4×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $10,265 $10,265 29.3×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $6,916 $6,916 28.9×
MRI lumbar spine w contrast (72149) $9,075 $9,075 25.9×
Mri Neck Spine W/O & W/Dye (72156) $10,265 $10,265 29.3×
MRI orbit face &/neck w/o contrast (70540) $6,086 $6,086 25.4×
MRI orbit face neck w contrast (70542) $9,075 $9,075 25.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $10,265 $10,265 29.3×
MRI pelvis w contrast (72196) $9,075 $9,075 25.9×
MRI pelvis w/o & w contrast (72197) $10,265 $10,265 29.3×
MRI pelvis w/o contrast (72195) $8,080 $8,080 33.7×
MRI spectroscopy (76390) $5,759 $5,759 65.9×
MRI thoracic spine w/o contrast (72146) $8,695 $8,695 36.3×
MRI upper extremity oth than jt w/contr matrl (73219) $9,075 $9,075 25.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $7,490 $7,490 31.2×
Mri Uppr Extremity W/O&W/Dye (73220) $10,265 $10,265 29.3×
MRI, abdomen, combo (74183) $10,265 $10,265 29.3×
MRI, dorsal spine combo (72157) $10,265 $10,265 29.3×
MRI, dorsal spine contrast (72147) $9,075 $9,075 25.9×
MRI, joint upper extrem (73221) $6,086 $6,086 25.4×
MRI, joint upper extrem combo (73223) $10,265 $10,265 29.3×
MRI, lumbar spine combo (72158) $12,204 $12,204 34.8×
Myelogram cervical (72240) $13,053 $13,053 16.6×
Myelogram Lumbar (72265) $7,196 $7,196 9.1×
Myelography thoracic (72255) $3,181 $3,181 4.0×
Myelograpy 2/more regions rs&i (72270) $13,053 $13,053 16.6×
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $3,075 $3,075 7.7×
Myocardial Imaging Pet Metabolic Evaluation (78459) $11,594 $11,594 8.9×
Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) $1,880 $1,880 3.4×
Neck soft tissue (70360) $418 $418 4.8×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $2,326 $2,326 6.0×
Nm csf leak detection (78650) $4,549 $4,549 3.5×
Nm myocard infarct spect (78469) $3,273 $3,273 6.0×
Nm red cell survival study (78130) $4,287 $4,287 10.7×
Nm whole blood volume (78122) $4,295 $4,295 7.9×
Nonvascular Shunt X-Ray (75809) $2,019 $2,019 19.2×
Ntsty modul radthx pln dose-vol histos (77301) $5,049 $5,049 3.6×
Nuclear Rx Intra-Arterial (79445) $3,450 $3,450 14.7×
Nuclear Rx Oral Admin (79005) $3,668 $3,668 15.6×
Ob us nuchal meas 1 gest (76813) $2,866 $2,866 27.3×
Oph bmtry us echograpy a-scan io lens pwr cal (76519) $1,948 $1,948 18.5×
Oph us dx ant sgm us immersion b-scan/hr biom (76513) $1,774 $1,774 16.9×
Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) $2,143 $2,143 16.0×
Ophthalmic Biometry US Echograpy a-Scan (76516) $1,948 $1,948 18.5×
Ophthalmic Ultrasonic Foreign Body Localization (76529) $2,866 $2,866 32.8×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $3,141 $3,141 29.9×
Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) $621 $621 21.4×
Ophthalmic us dx quantitative a-scan only (76511) $2,866 $2,866 27.3×
Optic foramina (70190) $2,019 $2,019 23.1×
Panoramic X-ray of jaws (70355) $1,262 $1,262 14.4×
Parathyroid Planar Imaging (78070) $7,069 $7,069 17.6×
Pelvis 1 or 2 views (72170) $684 $684 6.5×
Perineogram (74775) $5,637 $5,637 23.5×
Peritoneogram Rs&I (74190) $7,162 $7,162 13.0×
Pet Image Skull-Thigh (78812) $13,113 $13,113 9.1×
Pet Image W/Ct Lmtd (78814) $15,819 $15,819 11.0×
PET image w/CT, full body (78816) $27,332 $27,332 19.0×
PET imaging CT attenuation skull base mid-thigh (78815) $27,332 $27,332 19.0×
Pet Imaging Limited Area Chest Head/Neck (78811) $12,000 $12,000 9.2×
Pet Myocardial Sngl Study (78491) $12,581 $12,581 8.8×
PET whole body (78813) $15,305 $15,305 10.7×
Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) $4,287 $4,287 3.3×
Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) $4,287 $4,287 3.3×
Platelet survival study Non-Facility (78191) $2,415 $2,415 6.0×
Proton trmt simple w/comp (77522) $13,064 $13,064 10.4×
Proton tx delivery complex (77525) $18,150 $18,150 14.5×
Proton tx delivery intermediate (77523) $17,089 $17,089 13.6×
Proton tx delivery simple w/o compensation (77520) $10,345 $10,345 18.6×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $54,409 $54,409 17.2×
Pulmonary Perfusion Imaging Particulate (78580) $3,345 $3,345 8.3×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $1,262 $1,262 12.0×
Radex abscess/fistula/sinus tract rs&i (76080) $3,716 $3,716 6.8×
Radex Ankle Complete Minimum 3 Views (73610) $669 $669 7.7×
Radex elbow complete minimum 3 views (73080) $432 $432 4.9×
Radex Facial Bones Complete Minimum 3 Views (70150) $2,019 $2,019 19.2×
Radex foot complete minimum 3 views (73630) $669 $669 7.7×
Radex Hand Minimum 3 Views (73130) $669 $669 7.7×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $2,019 $2,019 19.2×
Radex Nasal Bones Complete Minimum 3 Views (70160) $2,019 $2,019 23.1×
Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) $3,390 $3,390 38.8×
Radex Ribs Unilateral 2 Views (71100) $695 $695 8.0×
Radex shoulder complete minimum 2 views (73030) $687 $687 7.9×
Radex Sinuses Paransl < 3 Views (70210) $390 $390 4.5×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $3,209 $3,209 18.2×
Radex Spine 1 View Specify Level (72020) $2,019 $2,019 23.1×
Radex Sternum Minimum 2 Views (71120) $410 $410 4.7×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $1,262 $1,262 14.4×
Radex Toe Minimum 2 Views (73660) $644 $644 7.4×
Radex Wrist Complete Minimum 3 Views (73110) $674 $674 7.7×
Radiation Delivery Stereotactic Cranial Linear (77372) $40,040 $40,040 5.4×
Radiation treatment delivery level 1 (77402) $1,387 $1,387 13.5×
Radiation treatment delivery level 2 (77407) $403 $403 1.0×
Radiation treatment delivery level 3 (77412) $1,576 $1,576 2.8×
Radiolog exam mandible compl minimum 4 views (70110) $2,019 $2,019 19.2×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $882 $882 8.4×
Radiologic exam colon double contrast study (74280) $3,209 $3,209 18.2×
Radiologic exam colon single contrast study (74270) $3,209 $3,209 18.2×
Radiologic exam knee complete 4/more views (73564) $2,019 $2,019 19.2×
Radiologic exam swallow function contrast study (74230) $2,161 $2,161 12.3×
Radiologic exam teeth complete full mouth (70320) $1,262 $1,262 5.3×
Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) $2,019 $2,019 8.4×
Radiologic exam upr gi trc double contrast study (74246) $3,209 $3,209 18.2×
Radiologic examination femur 1 view (73551) $1,262 $1,262 14.4×
Radiologic examination femur minimum 2 views (73552) $1,262 $1,262 14.4×
Radiologic examination knee 1/2 views (73560)
range across 2 matching MRF lines		 $387–$388 $387–$388 varies
Radiologic Examination Osseous Survey Limited (77074) $2,019 $2,019 19.2×
Radiologic Examination Salivary Gland Calculus (70380) $1,262 $1,262 14.4×
Radiologic examination tibia & fibula 2 views (73590) $692 $692 7.9×
Radiologic examination, teeth; single view Non-Facility (70300) $288 $288 3.3×
Radiopharm Dacryocystography (78660) $2,348 $2,348 5.8×
Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) $2,761 $2,761 11.8×
Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) $3,284 $3,284 14.0×
Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) $3,721 $3,721 15.9×
Red Cell Volume Determination Spx 1 Sampling (78120) $4,287 $4,287 10.7×
Red Cell Volume Determination Spx Mult Samplings (78121) $4,287 $4,287 7.9×
Renal Cyst Study (74470) $8,855 $8,855 16.1×
Ribs bilateral 3 views (71110) $513 $513 4.9×
Rp loclzj tum plnr 1 area single day imaging (78800) $3,284 $3,284 8.2×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $4,579 $4,579 11.4×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $8,235 $8,235 15.1×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $3,644 $3,644 6.7×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $5,677 $5,677 10.4×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $5,230 $5,230 22.3×
Rp Therapy Intravenous Administration (79101) $3,127 $3,127 13.3×
Salivary Gland Function Study (78232) $2,669 $2,669 6.6×
Salivary Gland Imaging (78230) $2,928 $2,928 7.3×
Salivary Gland Imaging Serial Images (78231) $2,928 $2,928 7.3×
Sella turcica (70240) $1,262 $1,262 14.4×
Shoulder 1 view (73020) $297 $297 3.4×
Sialogram (70390) $7,162 $7,162 29.9×
Skull less than 4 views (70250) $467 $467 4.4×
Special dosimetry (77331) $1,093 $1,093 8.1×
Special Physics Consult (77370) $646 $646 4.8×
Special teletherapy port plan (77321) $1,260 $1,260 3.3×
Special treatment procedure (77470) $5,755 $5,755 10.4×
Speech evaluation, complex (70371) $3,390 $3,390 14.1×
Spleen Imaging (78185) $3,116 $3,116 7.8×
Srs Multisource (77371) $36,043 $36,043 4.9×
Stereotactic Body Radiation Delivery (77373) $24,376 $24,376 13.6×
Sternoclavicular joints (71130) $2,019 $2,019 23.1×
Superior sagittal sinus venogram (75870) $7,162 $7,162 2.3×
Surface Applic Low Dose Rate Radionuclide Source (77789) $1,559 $1,559 15.2×
Temporomandble Jt Arthrography Rs&I (70332) $7,196 $7,196 30.0×
Testicular Imaging W/Flow (78761) $3,532 $3,532 8.8×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $3,147 $3,147 8.4×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $4,012 $4,012 10.7×
Ther rad simulaj-aided field setting simple (77280) $1,567 $1,567 11.6×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $3,209 $3,209 18.2×
Thoracic spine 2 views (72070) $1,740 $1,740 16.6×
Thoracic spine 3 views (72072) $699 $699 6.7×
Thoracolumbar 2 views (72080) $2,019 $2,019 23.1×
Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) $3,277 $3,277 8.2×
Thyroid Carcinoma Metastases Img Lmtd Area (78015) $2,744 $2,744 6.8×
Thyroid Met Imaging Body (78018) $5,131 $5,131 9.4×
Tx Devices Design & Construction Complex (77334) $2,518 $2,518 6.7×
Tx devices design & construction intermediate (77333) $2,093 $2,093 15.5×
Tx devices design & construction simple (77332) $1,623 $1,623 12.0×
Ultrasound Breast Limited (76642) $1,941 $1,941 22.2×
Ultrasound Exam Aaa Screen (76706) $618 $618 5.9×
Ultrasound, abdomen limited (76705) $1,594 $1,594 15.2×
Umbilical-artery Doppler (OB) (76820) $1,948 $1,948 18.5×
Unlisted Dx Radiographic Procedure (76499) $1,262 $1,262 14.4×
Unlisted fluoroscopic procedure (76496) $3,390 $3,390 38.8×
Unlisted magnetic resonance procedure (76498) $6,086 $6,086 69.6×
Unlisted us procedure (76999) $1,948 $1,948 22.3×
Upper gi w/o kub (74240) $3,209 $3,209 18.2×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $766 $766 69.3×
Urea breath test c-14 isotopic analysis (78268) $936 $936 9.9×
Ureteral Reflux Study (78740) $2,629 $2,629 6.5×
Urethrocystogram voiding (74455) $5,637 $5,637 23.5×
Urethrocystography retrograde (74450) $5,637 $5,637 23.5×
Us bone density measurement (76977) $1,113 $1,113 10.6×
Us breast unilateral complete (76641) $2,866 $2,866 27.3×
Us chest (76604) $2,866 $2,866 27.3×
Us complete joint (76881) $1,405 $1,405 13.4×
Us exam, pelvic, limited (76857) $2,550 $2,550 24.3×
Us head (76506) $2,866 $2,866 27.3×
Us kidney transplant (76776) $2,866 $2,866 27.3×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $1,521 $1,521 14.5×
Us ob detailed single fetus (76811) $2,866 $2,866 12.0×
Us ob limited 1 or more fetuses (76815) $2,300 $2,300 21.9×
Us ob transvaginal (76817) $2,866 $2,866 27.3×
Us pelvic non ob complete (76856) $2,204 $2,204 21.0×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $2,866 $2,866 27.3×
Us preg uterus real time f/u trnsabdl per fetus (76816) $2,866 $2,866 27.3×
Us retroperitoneal complete (76770) $2,866 $2,866 27.3×
Us retroperitoneal limited (76775) $1,755 $1,755 16.7×
Us scrotum and contents (76870) $1,590 $1,590 15.1×
Us spinal canal and contents (76800) $3,223 $3,223 30.7×
Us thyroid (76536) $2,866 $2,866 27.3×
Us transrectal (76872) $2,866 $2,866 27.3×
Vascular Flow Imaging (78445) $2,108 $2,108 5.2×
Vasogram (74440) $5,637 $5,637 23.5×
Vein X-Ray Chest (75827) $17,585 $17,585 11.1×
Vein X-Ray Liver W/O Hemodyn (75887) $17,585 $17,585 5.5×
Vein X-Ray Skull Epidural (75872) $17,585 $17,585 27.9×
Vein X-Ray Spleen/Liver (75810) $54,409 $54,409 17.2×
Venogram Sinus/Jugular (75860) $17,585 $17,585 5.5×
Venography Adrenal Unilateral (75840) $54,409 $54,409 17.2×
Venography caval inferior serialography rs&i (75825) $18,770 $18,770 5.9×
Venography extremity bilateral rs&i (75822) $17,281 $17,281 10.9×
Venography extremity unilateral rs&i (75820) $11,282 $11,282 7.1×
Venography Orbital Rs&I (75880) $17,585 $17,585 27.9×
Venography Renal Bilateral (75833) $54,409 $54,409 17.2×
Venography Renal Unilateral (75831) $41,698 $41,698 13.1×
Venous sampling by catheter (75893) $23,005 $23,005 4.1×
Venous thrombosis imaging (78457) $3,517 $3,517 6.4×
Venous Thrombosis Imaging Venogram Bilateral (78458) $3,517 $3,517 8.8×
X-ray antegrade pyelogram tube (74425) $5,637 $5,637 16.1×
X-Ray Aorta Leg Arteries (75630) $36,915 $36,915 11.6×
X-Ray Bend Only L-S Spine (72120) $706 $706 6.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $687 $687 7.9×
X-Ray Exam Breast Specimen (76098) $7,162 $7,162 13.0×
X-Ray Exam Entire Spi 2/3 Vw (72082) $1,677 $1,677 16.0×
X-Ray Exam Hip Uni 1 View (73501) $2,572 $2,572 29.4×
X-Ray Exam Hip Uni 2-3 Views (73502) $1,155 $1,155 13.2×
X-Ray Exam Hip Uni 4/> Views (73503) $1,691 $1,691 16.1×
X-Ray Exam Hips Bi 2 Views (73521) $1,318 $1,318 12.5×
X-Ray Exam Hips Bi 3-4 Views (73522) $2,019 $2,019 19.2×
X-Ray Exam Hips Bi 5/> Views (73523) $2,939 $2,939 28.0×
X-Ray Exam L-S Spine Bending (72114)
range across 2 matching MRF lines		 $1,018–$1,740 $1,018–$1,740 varies
X-Ray Exam Neck Spine 2-3 Vw (72040) $713 $713 8.2×
X-Ray Exam Neck Spine 6/>Vws (72052) $2,019 $2,019 19.2×
X-Ray Exam Unilat Ribs/Chest (71101) $47 $47 0.4×
X-ray eye for foreign body (70030) $2,019 $2,019 23.1×
X-ray head for orthodontia (70350) $2,019 $2,019 23.1×
X-ray humerus (73060) $374 $374 4.3×
X-ray IV pyelogram (ivp) (74400) $7,069 $7,069 40.1×
X-ray IV pyelogram+tomography (74415) $5,637 $5,637 32.0×
X-ray nose-rectum child f.b. (76010) $645 $645 7.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $2,019 $2,019 19.2×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $682 $682 6.5×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $373 $373 3.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $351 $351 4.0×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $716 $716 8.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $1,151 $1,151 11.0×
X-Ray Stress View (77071) $581 $581 6.6×
X-ray thoracic spine 4 vw (72074) $599 $599 5.7×
X-Ray Tmj Unilat (70328) $1,262 $1,262 14.4×
X-Ray Urinary Tract Exam With Contrast Material (74420) $5,637 $5,637 16.1×
X-Rays Bone Length Studies (77073) $2,019 $2,019 19.2×
X-Rays Bone Survey Complete (77075) $3,390 $3,390 32.3×
Xr c-spine 4 or 5 views (72050) $1,620 $1,620 15.4×
Xr facial bones less than 3 views (70140) $2,019 $2,019 23.1×
XR Mastoids < 3 Views Bilateral (70120) $1,262 $1,262 12.0×
Xr myelogram posterior fossa (70010) $13,053 $13,053 37.2×
Xr orbits complete 4 views (70200) $1,348 $1,348 12.8×
Xr Tomogram Single Plane (76100) $2,019 $2,019 19.2×

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.