Imaging prices at Ascension Saint Thomas Hospital West
Nashville, TN · every code in this section with a posted price and a Medicare benchmark.
346 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) | $1,717.29 | $5,724.30 | 1.3× |
| Abdomen 1 View (74018) | $99.72 | $332.40 | 1.2× |
| Abdomen 2 views (74019) | $83.18 | $277.25 | 0.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $528.71 | $1,762.35 | 1.4× |
| Angio internal mammary (75756) | $783.65 | $2,612.15 | 0.3× |
| Angio pulmonary bilat (75743) | $946.82 | $3,156.05 | 0.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $1,055.34 | $3,517.80 | 0.3× |
| Angiography extremity bilateral rs&i (75716) | $1,015.86 | $3,386.20 | 0.3× |
| Angiography extremity unilateral rs&i (75710) | $854.82 | $2,849.40 | 0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $815.37 | $2,717.90 | 0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $780.50 | $2,601.65 | 0.3× |
| Ankle 2 views (73600) | $81.39 | $271.30 | 1.0× |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$994.49 | $3,314.95 | 0.2× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$994.49 | $3,314.95 | 0.2× |
| Artery X-Rays Adrenal Gland (75731) | $897.47 | $2,991.55 | 0.3× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$994.49 | $3,314.95 | 0.2× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$994.49 | $3,314.95 | 0.2× |
| Arthrogram ankle (73615) | $194.49 | $648.30 | 0.6× |
| Arthrogram hip (73525) | $215.28 | $717.60 | 0.6× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$175.68–$175.71 | $585.60–$585.70 | varies |
| Bone Imaging 3 Phase (78315) | $738.80 | $2,462.65 | 1.9× |
| Bone Imaging Limited Area (78300) | $494.72 | $1,649.05 | 1.3× |
| Bone Imaging Whole Body (78306) | $556.61 | $1,855.35 | 1.5× |
| Brachytx isodose complex (77318) | $571.73 | $1,905.75 | 1.6× |
| Brain Image W/Flow < 4 Views (78601) | $503.97 | $1,679.90 | 1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $834.05 | $2,780.15 | 2.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,160.82 | $3,869.40 | 1.5× |
| Cat Scan Follow-Up Study (76380) | $235.70 | $785.65 | 2.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $691.43 | $2,304.75 | 1.3× |
| Cerebrospinal Fluid Scan (78630) | $908.91 | $3,029.70 | 1.7× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$90.29–$106.05 | $300.95–$353.50 | varies |
| Chest 2 views (71046) | $115.77 | $385.90 | 1.4× |
| Chest 3 views (71047) range across 2 matching MRF lines |
$89.87–$90.57 | $299.55–$301.90 | varies |
| Clavicle complete (73000) | $92.33 | $307.75 | 1.1× |
| Continuing medical physics consltj pr wk (77336) | $277.83 | $926.10 | 2.2× |
| Contrast Exam Abdominl Aorta (75625) | $1,101.51 | $3,671.70 | 0.4× |
| Contrast X-Ray Bladder (74430) | $473.94 | $1,579.80 | 1.4× |
| Contrast X-Ray Of Elbow (73085) | $205.79 | $685.95 | 0.6× |
| Contrast X-Ray Of Knee Joint (73580) | $194.49 | $648.30 | 0.6× |
| CT abdomen and pelvis without and with contrast (74178) | $1,946.21 | $6,487.35 | 5.8× |
| CT abdomen and pelvis without contrast (74176) | $1,409.82 | $4,699.40 | 6.2× |
| CT abdomen w contrast (74160) | $874.64 | $2,915.45 | 5.2× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,020.09–$1,020.27 | $3,400.30–$3,400.90 | varies |
| CT abdomen w/o contrast (74150) | $784.58 | $2,615.25 | 7.8× |
| CT Angio Abdomen and Pelvis (74174) | $1,707.77 | $5,692.55 | 5.1× |
| CT Angio Chest (71275) | $868.77 | $2,895.90 | 5.2× |
| CT Angio Head (70496) | $779.51 | $2,598.35 | 4.6× |
| CT angio hrt w/3d image (75574) | $1,085.27 | $3,617.55 | 3.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $731.75 | $2,439.15 | 4.3× |
| CT Angio Neck (70498) | $779.51 | $2,598.35 | 4.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $941.18 | $3,137.25 | 5.6× |
| CT cervical spine w/ contrast (72126) | $812.40 | $2,708 | 2.4× |
| CT cervical spine w/o contrast (72125) | $784.19 | $2,613.95 | 7.8× |
| CT cervical spine w/wo cont (72127) | $861.72 | $2,872.40 | 5.1× |
| CT chest w contrast (71260) | $882.89 | $2,942.95 | 5.2× |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$970.16–$1,044.56 | $3,233.85–$3,481.85 | varies |
| CT head/brain with contrast (70460) | $746.24 | $2,487.45 | 4.4× |
| CT head/brain without and with contrast (70470) | $802.22 | $2,674.05 | 4.8× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,008.18 | $3,360.60 | 3.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $101.15 | $337.15 | 1.2× |
| CT iac w contrast (70481) | $672.63 | $2,242.10 | 4.0× |
| CT l-spine w&w/o contrast (72133) | $861.72 | $2,872.40 | 5.1× |
| CT lower ext w/o (73700) | $640.52 | $2,135.05 | 6.4× |
| CT lower extremity w/contrast material (73701) | $687.89 | $2,292.95 | 4.1× |
| CT lumbar spine w contrast (72132) | $812.40 | $2,708 | 2.4× |
| CT lumbar spine w/o contrast (72131) | $746.63 | $2,488.75 | 7.4× |
| CT maxillofacial w contrast (70487) | $622.91 | $2,076.35 | 3.7× |
| CT maxillofacial wo contrast (70486) | $554.03 | $1,846.75 | 5.5× |
| CT neck tissue combo (70492) | $826.49 | $2,754.95 | 4.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $705.11 | $2,350.35 | 4.2× |
| CT orbits w/o contrast (70480) | $540.69 | $1,802.30 | 5.4× |
| CT pelvis w&w/o contrast (72194) | $926.33 | $3,087.75 | 5.5× |
| CT pelvis w/o contrast (72192) | $625.65 | $2,085.50 | 6.2× |
| CT scan of leg combo (73702) | $718.02 | $2,393.40 | 4.3× |
| CT scans face/jaw combo (70488) | $658.53 | $2,195.10 | 3.9× |
| CT soft tissue neck w contrast (70491) | $807.32 | $2,691.05 | 4.8× |
| CT soft tissue neck w/o contrast (70490) | $707.07 | $2,356.90 | 7.0× |
| CT thoracic spine w contrast (72129) | $745.83 | $2,486.10 | 4.4× |
| CT thoracic spine w/o contrast (72128) | $710.19 | $2,367.30 | 7.1× |
| CT thoracic spine w/wo cont (72130) | $835.10 | $2,783.65 | 5.0× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$659.72–$817.11 | $2,199.05–$2,723.70 | varies |
| CT upper ext wo (73200) | $573.59 | $1,911.95 | 5.7× |
| CT upper extremity w/o & w/contrast material (73202) | $811.20 | $2,704 | 4.8× |
| CT upper extremity with contrast (73201) | $668.72 | $2,229.05 | 2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $813.95 | $2,713.15 | 4.8× |
| Cta Abdomen (74175) | $856.64 | $2,855.45 | 5.1× |
| CTA pelvis (72191) | $851.15 | $2,837.15 | 5.1× |
| Dilation ureters/urethra rs&i (74485) | $416.43 | $1,388.10 | 0.2× |
| Discography Cerv/Thor Spine (72285) | $725.16 | $2,417.20 | 0.4× |
| Diskography lumbar (72295) | $787.17 | $2,623.90 | 0.4× |
| Dxa Bone Density Axial (77080) | $161.37 | $537.90 | 1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $69.42 | $231.40 | 0.8× |
| Echograp Trans R Pros Study (76873) | $241.58 | $805.25 | 2.4× |
| Esophagram (74220) | $173 | $576.65 | 1.0× |
| Fluoroscopy up to 1 hr (76000) range across 8 matching MRF lines |
$179.36–$491.19 | $597.85–$1,637.30 | varies |
| Follow-Up Angiography (75898) | $270.27 | $900.90 | 0.1× |
| Foot 2 views (73620) | $66.95 | $223.15 | 0.8× |
| Forearm 2 views (73090) | $86.67 | $288.90 | 1.0× |
| Gastric emptying imaging study (78264) | $418.64 | $1,395.45 | 1.1× |
| Gastroesophageal Reflux Exam (78262) | $289.59 | $965.30 | 0.8× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$715.65–$802.52 | $2,385.50–$2,675.05 | varies |
| GI Endoscopic US S&I (76975) | $159.75 | $532.50 | 0.7× |
| Hand 2 views (73120) | $87.17 | $290.55 | 0.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,809.11 | $6,030.35 | 2.7× |
| Heart Image (Pet) Multiple (78492) | $788.88 | $2,629.60 | 0.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $897.47 | $2,991.55 | 0.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $897.47 | $2,991.55 | 0.3× |
| Hepatobil Syst Image W/Drug (78227) | $647.19 | $2,157.30 | 1.2× |
| Hepatobiliary System Imaging (78226) | $647.19 | $2,157.30 | 1.7× |
| Ht Muscle Image Spect Sing (78451) | $1,895.22 | $6,317.40 | 1.5× |
| Interstitial radiation source applic complex (77778) | $3,474.99 | $11,583.30 | 5.2× |
| K Flow/Funct Image Multiple (78709) | $607.71 | $2,025.70 | 1.2× |
| K Flow/Funct Image W/Drug (78708) | $750.63 | $2,502.10 | 1.4× |
| K Flow/Funct Image W/O Drug (78707) | $568.20 | $1,894 | 1.1× |
| Knee 3 Views (73562) | $90.93 | $303.10 | 1.1× |
| Leveen/Shunt Patency Exam (78291) | $243.83 | $812.75 | 0.6× |
| Liver & Spleen Imaging Static Only (78215) | $541.35 | $1,804.50 | 1.4× |
| Liver imaging static only (78201) | $550.59 | $1,835.30 | 1.1× |
| Lung Perf&Ventilat Diferentl (78598) | $982.62 | $3,275.40 | 1.9× |
| Lung Ventilat&Perfus Imaging (78582) | $869.94 | $2,899.80 | 1.7× |
| Lung Ventilation Imaging (78579) | $323.34 | $1,077.80 | 0.8× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$718.80–$1,088.01 | $2,396–$3,626.70 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,138.98 | $3,796.60 | 0.8× |
| Lymphangiography extremity only unilateral rs&i (75801) | $446.75 | $1,489.15 | 0.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $2,266.86 | $7,556.20 | 0.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $2,266.86 | $7,556.20 | 0.7× |
| Magnetic Image Jaw Joint (70336) range across 3 matching MRF lines |
$612.53–$765.66 | $2,041.75–$2,552.20 | varies |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) | $4,643.76 | $15,479.20 | 27.6× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $4,628.64 | $15,428.80 | 8.8× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $4,643.76 | $15,479.20 | 27.6× |
| Mammary ductogram or galactogram multiple (77054) | $186.77 | $622.55 | 0.8× |
| Mammary ductogram or galactogram single (77053) | $186.77 | $622.55 | 0.8× |
| Meckels Divert Exam (78290) | $419.16 | $1,397.20 | 1.1× |
| Mlc imrt design & construction per imrt plan (77338) | $997.56 | $3,325.20 | 2.8× |
| Mr safety determination physician/other qhp (76016) | $75.90 | $253 | 0.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $21.11 | $70.35 | 0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $78.39 | $261.30 | 0.9× |
| Mr safety implt pos&/immoblj (76019) | $51.21 | $170.70 | 0.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $208.35 | $694.50 | 0.9× |
| Mra Head W/O & W/Contrast Material (70546) | $1,187.03 | $3,956.75 | 3.5× |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$780.39–$780.50 | $2,601.30–$2,601.65 | varies |
| MRA head with contrast (70545) | $897.47 | $2,991.55 | 2.7× |
| MRA neck w contrast (70548) | $859.07 | $2,863.55 | 2.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $987.66 | $3,292.20 | 3.0× |
| MRA neck w/o contrast (70547) | $747.02 | $2,490.05 | 3.3× |
| MRI abdomen w contrast (74182) | $1,085.64 | $3,618.80 | 3.2× |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$943.89–$943.97 | $3,146.30–$3,146.55 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $846.02 | $2,820.05 | 1.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $972.87 | $3,242.90 | 2.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $990.14 | $3,300.45 | 1.3× |
| MRI cardiac w/o contrast (75557) | $630.71 | $2,102.35 | 2.8× |
| MRI cervical spine w contrast (72142) | $1,152.21 | $3,840.70 | 3.4× |
| MRI cervical spine w/o cont (72141) | $1,002.12 | $3,340.40 | 4.4× |
| MRI chest w/o contrast (71550) | $897.12 | $2,990.40 | 3.9× |
| MRI chest with contrast (71551) | $1,031.73 | $3,439.10 | 1.4× |
| MRI chest wo w contrast (71552) | $1,186.41 | $3,954.70 | 3.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,015.17 | $3,383.90 | 3.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,167.39 | $3,891.30 | 3.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $882.66 | $2,942.20 | 3.9× |
| MRI lumbar spine w contrast (72149) | $1,152.21 | $3,840.70 | 3.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,325.22 | $4,417.40 | 4.0× |
| MRI orbit face &/neck w/o contrast (70540) | $870.69 | $2,902.30 | 3.8× |
| MRI orbit face neck w contrast (70542) | $1,002.12 | $3,340.40 | 3.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,152.21 | $3,840.70 | 3.4× |
| MRI pelvis w contrast (72196) | $948.54 | $3,161.80 | 2.8× |
| MRI pelvis w/o & w contrast (72197) | $1,090.92 | $3,636.40 | 3.3× |
| MRI pelvis w/o contrast (72195) | $824.88 | $2,749.60 | 3.6× |
| MRI thoracic spine w/o contrast (72146) | $1,002.12 | $3,340.40 | 4.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $905.22 | $3,017.40 | 2.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $787.17 | $2,623.90 | 3.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,041.24 | $3,470.80 | 3.1× |
| MRI, abdomen, combo (74183) | $1,248.42 | $4,161.40 | 3.7× |
| MRI, dorsal spine combo (72157) | $1,325.22 | $4,417.40 | 4.0× |
| MRI, dorsal spine contrast (72147) | $1,152.21 | $3,840.70 | 3.4× |
| MRI, joint upper extrem (73221) | $861.18 | $2,870.60 | 3.8× |
| MRI, joint upper extrem combo (73223) | $1,138.83 | $3,796.10 | 3.4× |
| MRI, lumbar spine combo (72158) | $1,325.22 | $4,417.40 | 4.0× |
| Musculoskeletal Nuclear Exam (78399) | $542.78 | $1,809.25 | 1.4× |
| Myelogram cervical (72240) | $509.51 | $1,698.35 | 0.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $734.81 | $2,449.35 | 0.6× |
| Myocardial Spect Multiple Studies (78452) | $2,450.22 | $8,167.40 | 2.0× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $788.76 | $2,629.20 | 0.6× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $788.76 | $2,629.20 | 0.6× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $790.86 | $2,636.20 | 0.4× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $1,007.75 | $3,359.15 | 0.5× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $1,007.75 | $3,359.15 | 0.7× |
| N-invas est c ffr sw aly CTA (75580) | $2,413.53 | $8,045.10 | 2.9× |
| Neck soft tissue (70360) | $94.07 | $313.55 | 1.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $252.27 | $840.90 | 0.7× |
| Nm myocard infarct spect (78469) | $458.67 | $1,528.90 | 0.9× |
| Nm red cell survival study (78130) | $518.16 | $1,727.20 | 1.4× |
| Nm whole blood volume (78122) range across 2 matching MRF lines |
$656.66–$2,931.02 | $2,188.85–$9,770.05 | varies |
| Nonvascular Shunt X-Ray (75809) range across 3 matching MRF lines |
$336.15–$360.11 | $1,120.50–$1,200.35 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,288.09 | $10,960.30 | 2.5× |
| Nuclear medicine study of endocrine organs (78099) | $569.91 | $1,899.70 | 1.5× |
| Nuclear Rx Intra-Arterial (79445) | $453.33 | $1,511.10 | 2.0× |
| Nuclear Rx Oral Admin (79005) | $481.85 | $1,606.15 | 2.2× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $206.72 | $689.05 | 2.1× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $178.55 | $595.15 | 1.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $249.02 | $830.05 | 2.5× |
| Ophthalmic us dx quantitative a-scan only (76511) | $178.55 | $595.15 | 1.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,096.34 | $3,654.45 | 2.1× |
| Parathyroid Planar Imaging (78070) | $539.24 | $1,797.45 | 1.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,311.71 | $4,372.35 | 3.4× |
| Pelvis 1 or 2 views (72170) | $90.57 | $301.90 | 0.9× |
| Pet Myocardial Sngl Study (78491) | $788.76 | $2,629.20 | 0.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,380.90 | $4,603 | 0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $545.01 | $1,816.70 | 1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $136.02 | $453.40 | 1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $174.78 | $582.60 | 0.3× |
| Radex Ankle Complete Minimum 3 Views (73610) | $82.80 | $276 | 1.0× |
| Radex Calcaneus Minimum 2 Views (73650) | $75.41 | $251.35 | 0.9× |
| Radex elbow complete minimum 3 views (73080) | $85.98 | $286.60 | 1.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $113.81 | $379.35 | 1.1× |
| Radex fingr minimum 2 views (73140) | $75.41 | $251.35 | 0.9× |
| Radex foot complete minimum 3 views (73630) | $82.13 | $273.75 | 1.0× |
| Radex Hand Minimum 3 Views (73130) | $86.67 | $288.90 | 1.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $118.41 | $394.70 | 1.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $91.26 | $304.20 | 1.1× |
| Radex Ribs Unilateral 2 Views (71100) | $104.31 | $347.70 | 1.2× |
| Radex shoulder complete minimum 2 views (73030) | $94.07 | $313.55 | 1.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $77.18 | $257.25 | 0.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $527.13 | $1,757.10 | 3.1× |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$91.95–$92.33 | $306.50–$307.75 | varies |
| Radex Sternum Minimum 2 Views (71120) | $106.43 | $354.75 | 1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $118.41 | $394.70 | 1.4× |
| Radex Toe Minimum 2 Views (73660) | $82.13 | $273.75 | 1.0× |
| Radex Wrist Complete Minimum 3 Views (73110) | $84.90 | $283 | 1.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 2 matching MRF lines |
$3,525.80–$7,545.93 | $11,752.65–$25,153.10 | varies |
| Radiation treatment delivery level 1 (77402) | $171.50 | $571.65 | 1.8× |
| Radiation treatment delivery level 2 (77407) | $155.90 | $519.65 | 0.4× |
| Radiation treatment delivery level 3 (77412) | $264.74 | $882.45 | 0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $149.40 | $498 | 1.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $108.54 | $361.80 | 1.1× |
| Radiologic exam colon double contrast study (74280) | $286.13 | $953.75 | 1.7× |
| Radiologic exam colon single contrast study (74270) | $179.36 | $597.85 | 1.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $173 | $576.65 | 1.0× |
| Radiologic exam knee complete 4/more views (73564) | $120.17 | $400.55 | 1.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $69.08 | $230.25 | 0.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $257.81 | $859.35 | 1.5× |
| Radiologic exam swallow function contrast study (74230) | $167.01 | $556.70 | 1.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $202.23 | $674.10 | 1.2× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$96.20–$106.05 | $320.65–$353.50 | varies |
| Radiologic examination femur minimum 2 views (73552) | $106.05 | $353.50 | 1.3× |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$94.07–$94.44 | $313.55–$314.80 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $174.78 | $582.60 | 1.7× |
| Radiologic examination tibia & fibula 2 views (73590) | $88.44 | $294.80 | 1.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $168.95 | $563.15 | 0.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $721.88 | $2,406.25 | 1.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $492.90 | $1,643 | 0.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $772.52 | $2,575.05 | 1.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $607.16 | $2,023.85 | 2.7× |
| Rp Therapy Intravenous Administration (79101) | $607.16 | $2,023.85 | 2.7× |
| Scapula (73010) | $85.62 | $285.40 | 0.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $32.45 | $108.15 | 1.4× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$63.08–$116.42 | $210.25–$388.05 | varies |
| Shoulder Arthrography (73040) | $200.49 | $668.30 | 0.6× |
| Skull less than 4 views (70250) | $95.84 | $319.45 | 1.0× |
| Special dosimetry (77331) | $244.74 | $815.80 | 1.9× |
| Special Physics Consult (77370) | $396.15 | $1,320.50 | 3.1× |
| Special teletherapy port plan (77321) | $1,086.99 | $3,623.30 | 3.0× |
| Special treatment procedure (77470) | $785.24 | $2,617.45 | 1.5× |
| Stereotactic Body Radiation Delivery (77373) | $1,646.52 | $5,488.40 | 1.0× |
| Sternoclavicular joints (71130) | $82.44 | $274.80 | 1.0× |
| Superior sagittal sinus venogram (75870) | $913.80 | $3,046 | 0.3× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $129.47 | $431.55 | 1.6× |
| Tbs technical calculation only (77091) | $129.47 | $431.55 | 1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,086.99 | $3,623.30 | 3.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $370.44 | $1,234.80 | 1.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 3 matching MRF lines |
$473.97–$836.66 | $1,579.90–$2,788.85 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$398.25–$760.94 | $1,327.50–$2,536.45 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$298.59–$661.28 | $995.30–$2,204.25 | varies |
| Thoracic spine 2 views (72070) | $108.20 | $360.65 | 1.1× |
| Thoracic spine 3 views (72072) | $140.25 | $467.50 | 1.4× |
| Thoracolumbar 2 views (72080) | $108.20 | $360.65 | 1.3× |
| Thyroid Imaging With Vascular Flow (78013) | $370.20 | $1,234 | 1.0× |
| Thyroid Met Imaging Body (78018) | $576.63 | $1,922.10 | 1.1× |
| Thyroid Uptake Measurement (78012) | $325.98 | $1,086.60 | 0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $538.16 | $1,793.85 | 1.4× |
| Tx Devices Design & Construction Complex (77334) | $308.12 | $1,027.05 | 0.9× |
| Tx devices design & construction intermediate (77333) | $190.83 | $636.10 | 1.5× |
| Tx devices design & construction simple (77332) | $136.28 | $454.25 | 1.1× |
| Ultrasound Breast Limited (76642) range across 9 matching MRF lines |
$165.20–$330.39 | $550.65–$1,101.30 | varies |
| Ultrasound elastography first target lesion (76982) | $369.77 | $1,232.55 | 3.7× |
| Ultrasound Exam Aaa Screen (76706) | $170.31 | $567.70 | 1.7× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$227.54–$227.85 | $758.45–$759.50 | varies |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) | $569.91 | $1,899.70 | 1.5× |
| Upper gi w/o kub (74240) | $217.79 | $725.95 | 1.3× |
| Urethrocystogram voiding (74455) | $242.43 | $808.10 | 1.1× |
| Urethrocystography retrograde (74450) | $342.51 | $1,141.70 | 1.5× |
| Us breast unilateral complete (76641) range across 9 matching MRF lines |
$173.48–$346.94 | $578.25–$1,156.45 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$188.24–$188.33 | $627.45–$627.75 | varies |
| Us complete joint (76881) | $209.46 | $698.20 | 2.1× |
| Us exam, pelvic, limited (76857) | $156.23 | $520.75 | 1.6× |
| Us kidney transplant (76776) | $570.44 | $1,901.45 | 5.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$209.33–$209.46 | $697.75–$698.20 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$163.01–$163.28 | $543.35–$544.25 | varies |
| Us ob transvaginal (76817) | $304.19 | $1,013.95 | 3.0× |
| Us pelvic non ob complete (76856) | $286.97 | $956.55 | 2.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$253.16–$253.32 | $843.85–$844.40 | varies |
| Us retroperitoneal complete (76770) | $280.32 | $934.40 | 2.8× |
| Us retroperitoneal limited (76775) | $252.51 | $841.70 | 2.5× |
| Us scrotum and contents (76870) | $264.30 | $881 | 2.6× |
| Us thyroid (76536) range across 2 matching MRF lines |
$200.28–$200.45 | $667.60–$668.15 | varies |
| Vein X-Ray Chest (75827) | $1,338.96 | $4,463.20 | 0.9× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $559.20 | $1,864 | 0.2× |
| Vein X-Ray Spleen/Liver (75810) | $1,751.63 | $5,838.75 | 0.6× |
| Venogram Sinus/Jugular (75860) | $822.42 | $2,741.40 | 0.3× |
| Venography Adrenal Unilateral (75840) | $897.47 | $2,991.55 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $2,712.93 | $9,043.10 | 0.9× |
| Venography extremity bilateral rs&i (75822) | $1,338.96 | $4,463.20 | 0.9× |
| Venography extremity unilateral rs&i (75820) | $1,338.96 | $4,463.20 | 0.9× |
| Venography Renal Bilateral (75833) | $897.47 | $2,991.55 | 0.3× |
| Venography Renal Unilateral (75831) | $897.47 | $2,991.55 | 0.3× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$994.49 | $3,314.95 | 0.2× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$61.31–$103.49 | $204.35–$344.95 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $83.87 | $279.55 | 1.0× |
| X-Ray Aorta Leg Arteries (75630) | $916.14 | $3,053.80 | 0.3× |
| X-Ray Bend Only L-S Spine (72120) | $139.19 | $463.95 | 1.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $87.41 | $291.35 | 1.0× |
| X-Ray Exam Breast Specimen (76098) | $142.64 | $475.45 | 0.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $181.80 | $606 | 2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$191.21–$191.36 | $637.35–$637.85 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 4 matching MRF lines |
$191.21–$200.78 | $637.35–$669.25 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $291.93 | $973.10 | 2.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $291.93 | $973.10 | 2.9× |
| X-Ray Exam L-S Spine Bending (72114) | $244.16 | $813.85 | 2.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $127.55 | $425.15 | 1.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $223.76 | $745.85 | 2.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $111 | $370 | 1.1× |
| X-ray humerus (73060) | $97.26 | $324.20 | 1.2× |
| X-ray IV pyelogram (ivp) (74400) | $284.01 | $946.70 | 1.7× |
| X-ray IV pyelogram+tomography (74415) | $251.94 | $839.80 | 1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $128.24 | $427.45 | 1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $122.97 | $409.90 | 1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $150.80 | $502.65 | 1.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $131.09 | $436.95 | 1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $125.45 | $418.15 | 1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $130.37 | $434.55 | 1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $135.30 | $451 | 1.3× |
| X-ray thoracic spine 4 vw (72074) | $139.19 | $463.95 | 1.4× |
| X-Ray Tmj Unilat (70328) | $97.26 | $324.20 | 1.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $383.01 | $1,276.70 | 1.1× |
| X-Rays Bone Survey Complete (77075) | $350.94 | $1,169.80 | 3.5× |
| Xr c-spine 4 or 5 views (72050) | $146.24 | $487.45 | 1.5× |
| Xr facial bones less than 3 views (70140) | $93.36 | $311.20 | 1.1× |
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.