Imaging prices at Ascension Seton Southwest
Austin, TX · every code in this section with a posted price and a Medicare benchmark.
427 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) range across 2 matching MRF lines |
$1,992.06–$2,071.89 | $5,533.50–$5,755.25 | varies |
| Abdomen 1 View (74018) | $343.17 | $953.25 | 3.9× |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$340.92–$421.65 | $947–$1,171.25 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,040.40 | $2,890 | 2.6× |
| Angio internal mammary (75756) range across 4 matching MRF lines |
$1,269.90–$1,396.98 | $3,527.50–$3,880.50 | varies |
| Angio pulmonary bilat (75743) | $3,686.58 | $10,240.50 | 1.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $4,064.76 | $11,291 | 1.3× |
| Angiography extremity bilateral rs&i (75716) | $3,488.67 | $9,690.75 | 1.1× |
| Angiography extremity unilateral rs&i (75710) range across 9 matching MRF lines |
$3,162.87–$3,171.51 | $8,785.75–$8,809.75 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,318.12 | $9,217 | 1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,313.91 | $3,649.75 | 0.4× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$231.03–$462.15 | $641.75–$1,283.75 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,763.28 | $4,898 | 0.3× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,300.04 | $6,389 | 0.4× |
| Artery X-Rays Adrenal Gland (75731) | $3,561.30 | $9,892.50 | 1.1× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,538.45 | $7,051.25 | 0.5× |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$2,580.57–$5,156.91 | $7,168.25–$14,324.75 | varies |
| Arthrogram ankle (73615) | $537.75 | $1,493.75 | 1.5× |
| Arthrogram hip (73525) range across 4 matching MRF lines |
$537.75–$843.39 | $1,493.75–$2,342.75 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$537.75–$553.68 | $1,493.75–$1,538 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$218.79–$227.52 | $607.75–$632 | varies |
| Bone age studies (77072) | $87.39 | $242.75 | 0.8× |
| Bone Imaging 3 Phase (78315) | $1,273.32 | $3,537 | 3.2× |
| Bone Imaging Limited Area (78300) | $368.19 | $1,022.75 | 0.9× |
| Bone Imaging Whole Body (78306) | $1,112.40 | $3,090 | 2.8× |
| Bone marrow imaging limited area (78102) | $1,037.34 | $2,881.50 | 2.6× |
| Bone survey infant (77076) | $165.60 | $460 | 1.6× |
| Brachytx isodose complex (77318) range across 2 matching MRF lines |
$399.87–$415.89 | $1,110.75–$1,155.25 | varies |
| Brachytx isodose intermed (77317) | $387.18 | $1,075.50 | 1.0× |
| Brachytx Isodose Plan Simple (77316) | $151.02 | $419.50 | 0.4× |
| Brain Image W/Flow < 4 Views (78601) | $543.78 | $1,510.50 | 1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $852.12 | $2,367 | 1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,640.87 | $7,335.75 | 1.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,080.27 | $3,000.75 | 3.1× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $4,415.13 | $12,264.25 | 5.6× |
| Cat Scan Follow-Up Study (76380) | $139.23 | $386.75 | 1.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $382.05 | $1,061.25 | 0.7× |
| Cerebrospinal Fluid Scan (78630) | $1,134.27 | $3,150.75 | 2.1× |
| Chest 1 view (71045) range across 5 matching MRF lines |
$269.01–$301.23 | $747.25–$836.75 | varies |
| Chest 2 views (71046) range across 5 matching MRF lines |
$287.91–$301.23 | $799.75–$836.75 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$158.31–$288.81 | $439.75–$802.25 | varies |
| Chest 4 or more views (71048) | $159.57 | $443.25 | 1.5× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$283.41–$567.27 | $787.25–$1,575.75 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $113.85 | $316.25 | 1.1× |
| Contrast Exam Abdominl Aorta (75625) | $1,884.33 | $5,234.25 | 0.6× |
| Contrast X-Ray Bladder (74430) range across 3 matching MRF lines |
$670.23–$770.85 | $1,861.75–$2,141.25 | varies |
| Contrast X-Ray Of Elbow (73085) | $537.75 | $1,493.75 | 1.5× |
| Contrast X-Ray Of Knee Joint (73580) | $669.24 | $1,859 | 1.9× |
| Contrast Xray Throat/Cerv Esopha (74210) | $512.37 | $1,423.25 | 2.9× |
| CT abdomen and pelvis without and with contrast (74178) | $3,543.57 | $9,843.25 | 10.1× |
| CT abdomen and pelvis without contrast (74176) | $2,440.26 | $6,778.50 | 10.2× |
| CT abdomen w contrast (74160) | $1,397.88 | $3,883 | 7.9× |
| CT abdomen w wo contrast (74170) | $1,524.24 | $4,234 | 8.7× |
| CT abdomen w/o contrast (74150) | $1,203.12 | $3,342 | 11.5× |
| CT Angio Abdomen and Pelvis (74174) | $3,269.34 | $9,081.50 | 9.3× |
| CT Angio Chest (71275) | $487.62 | $1,354.50 | 2.8× |
| CT Angio Head (70496) | $390.24 | $1,084 | 2.2× |
| CT angio hrt w/3d image (75574) | $655.74 | $1,821.50 | 1.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$1,438.83–$2,867.67 | $3,996.75–$7,965.75 | varies |
| CT Angio Neck (70498) | $364.59 | $1,012.75 | 2.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $938.79 | $2,607.75 | 5.3× |
| CT bone density (77078) | $532.44 | $1,479 | 6.1× |
| CT cervical spine w/ contrast (72126) | $1,695.06 | $4,708.50 | 4.8× |
| CT cervical spine w/o contrast (72125) | $1,637.64 | $4,549 | 15.6× |
| CT cervical spine w/wo cont (72127) | $2,055.15 | $5,708.75 | 11.7× |
| CT chest w contrast (71260) | $2,120.67 | $5,890.75 | 12.0× |
| CT chest w/wo contrast (71270) | $2,218.59 | $6,162.75 | 12.6× |
| CT colonography screening (74263) | $391.68 | $1,088 | 1.6× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $321.03 | $891.75 | 1.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $267.12 | $742 | 2.5× |
| CT head/brain with contrast (70460) | $1,473.66 | $4,093.50 | 8.4× |
| CT head/brain without and with contrast (70470) | $1,652.58 | $4,590.50 | 9.4× |
| CT heart contrast eval cardiac structure&morph (75572) | $803.97 | $2,233.25 | 2.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $45.18 | $125.50 | 0.5× |
| CT hrt w/3d image congen (75573) | $803.97 | $2,233.25 | 2.3× |
| CT iac w contrast (70481) | $1,261.08 | $3,503 | 7.2× |
| CT l-spine w&w/o contrast (72133) | $1,382.31 | $3,839.75 | 7.8× |
| CT lower ext w/o (73700) | $851.49 | $2,365.25 | 8.1× |
| CT lower extremity w/contrast material (73701) | $981.90 | $2,727.50 | 5.6× |
| CT lumbar spine w contrast (72132) | $828.99 | $2,302.75 | 2.4× |
| CT lumbar spine w/o contrast (72131) | $547.83 | $1,521.75 | 5.2× |
| CT maxillofacial w contrast (70487) | $1,389.24 | $3,859 | 7.9× |
| CT maxillofacial wo contrast (70486) range across 7 matching MRF lines |
$1,068.93–$1,292.04 | $2,969.25–$3,589 | varies |
| CT neck tissue combo (70492) | $1,389.24 | $3,859 | 7.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,192.22 | $6,089.50 | 12.4× |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$1,061.01–$1,121.31 | $2,947.25–$3,114.75 | varies |
| CT pelvis w&w/o contrast (72194) | $1,503.18 | $4,175.50 | 8.5× |
| CT pelvis w/o contrast (72192) | $1,180.89 | $3,280.25 | 11.2× |
| CT scan of leg combo (73702) | $1,052.28 | $2,923 | 6.0× |
| CT scans face/jaw combo (70488) | $1,526.76 | $4,241 | 8.7× |
| CT soft tissue neck w contrast (70491) | $1,293.93 | $3,594.25 | 7.3× |
| CT soft tissue neck w/o contrast (70490) | $798.57 | $2,218.25 | 7.6× |
| CT thoracic spine w contrast (72129) | $828.99 | $2,302.75 | 4.7× |
| CT thoracic spine w/o contrast (72128) | $547.83 | $1,521.75 | 5.2× |
| CT thoracic spine w/wo cont (72130) | $1,382.31 | $3,839.75 | 7.8× |
| CT thorax w/o contrast (71250) | $378.27 | $1,050.75 | 3.6× |
| CT upper ext wo (73200) | $1,404.36 | $3,901 | 13.4× |
| CT upper extremity w/o & w/contrast material (73202) | $1,595.25 | $4,431.25 | 9.1× |
| CT upper extremity with contrast (73201) | $1,455.39 | $4,042.75 | 4.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,433.88 | $3,983 | 8.1× |
| Cta Abdomen (74175) | $1,732.41 | $4,812.25 | 9.8× |
| CTA pelvis (72191) | $530.55 | $1,473.75 | 3.0× |
| Dilation ureters/urethra rs&i (74485) | $420.48 | $1,168 | 0.2× |
| Discography Cerv/Thor Spine (72285) | $5,291.37 | $14,698.25 | 2.7× |
| Diskography lumbar (72295) | $1,954.44 | $5,429 | 1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $225.09 | $625.25 | 2.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $225.09 | $625.25 | 2.1× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$143.91–$166.23 | $399.75–$461.75 | varies |
| Dxa Bone Density Axial (77080) | $300.60 | $835 | 2.9× |
| Dxa bone density study (77085) | $210.42 | $584.50 | 2.0× |
| Echo exam of fetal heart (76825) | $756.27 | $2,100.75 | 1.4× |
| Echo exam uterus (76831) | $465.48 | $1,293 | 1.9× |
| Echo Guide For Artery Repair (76936) | $878.22 | $2,439.50 | 4.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,038.06 | $2,883.50 | 4.3× |
| Echograp Trans R Pros Study (76873) | $465.48 | $1,293 | 4.4× |
| Esophagram (74220) | $298.98 | $830.50 | 1.7× |
| Fetal Biophys Profile W/Nst (76818) | $274.32 | $762 | 2.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $161.91 | $449.75 | 1.5× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $453.87 | $1,260.75 | 1.9× |
| Fluoroscopy up to 1 hr (76000) | $569.16 | $1,581 | 2.4× |
| Follow-Up Angiography (75898) | $536.40 | $1,490 | 0.2× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$255.51–$511.38 | $709.75–$1,420.50 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$282.06–$562.32 | $783.50–$1,562 | varies |
| Gastric emptying imaging study (78264) | $374.85 | $1,041.25 | 0.9× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $705.15 | $1,958.75 | 1.8× |
| Gastric Mucosa Imaging (78261) | $917.28 | $2,548 | 2.3× |
| Gastroesophageal Reflux Exam (78262) | $917.28 | $2,548 | 2.3× |
| Gated Heart Planar Single (78472) | $1,048.23 | $2,911.75 | 2.6× |
| Gated Heart, Multiple (78473) | $1,806.21 | $5,017.25 | 4.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,018.89 | $2,830.25 | 1.9× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$261.18–$522.27 | $725.50–$1,450.75 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) range across 2 matching MRF lines |
$536.85–$558.36 | $1,491.25–$1,551 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$536.85–$558.36 | $1,491.25–$1,551 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 2 matching MRF lines |
$536.85–$558.36 | $1,491.25–$1,551 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,064.76 | $11,291 | 1.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,757.05 | $10,436.25 | 1.2× |
| Hepatobil Syst Image W/Drug (78227) | $1,513.26 | $4,203.50 | 2.8× |
| Hepatobiliary System Imaging (78226) | $1,007.55 | $2,798.75 | 2.5× |
| Ht Musc Image Planar Mult (78454) | $3,200.94 | $8,891.50 | 2.5× |
| Ht Muscle Image Spect Sing (78451) | $1,163.25 | $3,231.25 | 0.9× |
| Hysterosalpingogram (74740) | $555.39 | $1,542.75 | 2.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $162.72 | $452 | 1.9× |
| Infant hip ultrasound, limited static exam (76886) | $93.33 | $259.25 | 1.1× |
| Interstitial radiation source applic complex (77778) range across 3 matching MRF lines |
$1,933.74–$4,517.55 | $5,371.50–$12,548.75 | varies |
| Intracavitary Radiation Source Applic Complex (77763) | $835.83 | $2,321.75 | 1.2× |
| Intracavitary Radiation Source Applic Intermed (77762) | $835.83 | $2,321.75 | 1.5× |
| Intracavitary radiation source applic simple (77761) | $835.83 | $2,321.75 | 1.5× |
| Joint Survey Single View (77077) | $261.18 | $725.50 | 2.5× |
| K Flow/Funct Image Multiple (78709) range across 8 matching MRF lines |
$1,180.80–$1,204.47 | $3,280–$3,345.75 | varies |
| K Flow/Funct Image W/Drug (78708) range across 3 matching MRF lines |
$1,180.80–$1,419.48 | $3,280–$3,943 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 10 matching MRF lines |
$1,112.40–$1,409.67 | $3,090–$3,915.75 | varies |
| Kidney Imaging Morphol (78700) | $1,180.80 | $3,280 | 2.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 5 matching MRF lines |
$1,180.80–$1,237.14 | $3,280–$3,436.50 | varies |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$367.29–$610.92 | $1,020.25–$1,697 | varies |
| Leveen/Shunt Patency Exam (78291) | $353.07 | $980.75 | 0.9× |
| Liver & Spleen Imaging Static Only (78215) | $832.68 | $2,313 | 2.1× |
| Liver imaging static only (78201) | $406.35 | $1,128.75 | 0.7× |
| Lung Perf&Ventilat Diferentl (78598) | $705.33 | $1,959.25 | 1.3× |
| Lung perfusion differential (78597) | $506.34 | $1,406.50 | 1.3× |
| Lung Ventilat&Perfus Imaging (78582) | $1,231.11 | $3,419.75 | 2.3× |
| Lung Ventilation Imaging (78579) | $327.06 | $908.50 | 0.8× |
| Lymph System Imaging (78195) | $448.74 | $1,246.50 | 0.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,407.15 | $3,908.75 | 0.9× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,407.15 | $3,908.75 | 2.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $4,854.51 | $13,484.75 | 1.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,407.15 | $3,908.75 | 0.4× |
| Magnetic Image Jaw Joint (70336) | $564.75 | $1,568.75 | 2.4× |
| Magnetic Resonance Elastography (76391) | $375.66 | $1,043.50 | 1.6× |
| Mammary ductogram or galactogram multiple (77054) | $535.50 | $1,487.50 | 2.2× |
| Mammary ductogram or galactogram single (77053) range across 4 matching MRF lines |
$588.87–$600.12 | $1,635.75–$1,667 | varies |
| Meckels Divert Exam (78290) | $726.12 | $2,017 | 1.8× |
| Mlc imrt design & construction per imrt plan (77338) | $638.46 | $1,773.50 | 1.7× |
| Mr safety determination physician/other qhp (76016) | $120.51 | $334.75 | 1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $33.48 | $93 | 1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $125.19 | $347.75 | 1.3× |
| Mr safety implt pos&/immoblj (76019) | $81.63 | $226.75 | 1.4× |
| Mr safety med physics xm customization plng&mntr (76017) | $329.31 | $914.75 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $2,785.50 | $7,737.50 | 7.9× |
| MRA head w/o contrast (70544) | $901.08 | $2,503 | 3.8× |
| MRA head with contrast (70545) | $1,358.01 | $3,772.25 | 3.9× |
| MRA neck w contrast (70548) | $1,011.78 | $2,810.50 | 2.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,232.46 | $3,423.50 | 3.5× |
| MRA neck w/o contrast (70547) | $838.62 | $2,329.50 | 3.5× |
| MRI abdomen w contrast (74182) | $1,845.72 | $5,127 | 5.3× |
| MRI abdomen w/o contrast (74181) | $1,702.71 | $4,729.75 | 7.1× |
| MRI any jt lower extrem w/contrast material (73722) | $847.62 | $2,354.50 | 1.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,188.81 | $3,302.25 | 3.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,757.61 | $4,882.25 | 2.2× |
| MRI brain functional w/o physician admnistration (70554) | $1,108.80 | $3,080 | 4.6× |
| MRI brain functional w/physician admnistration (70555) | $1,509.30 | $4,192.50 | 6.3× |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$375.66–$1,108.80 | $1,043.50–$3,080 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 3 matching MRF lines |
$375.66–$800.64 | $1,043.50–$2,224 | varies |
| MRI cardiac w/o cont stress (75559) | $1,108.80 | $3,080 | 2.0× |
| MRI cardiac w/o contrast (75557) | $403.38 | $1,120.50 | 1.7× |
| MRI cervical spine w contrast (72142) | $2,216.52 | $6,157 | 6.3× |
| MRI cervical spine w/o cont (72141) | $1,871.10 | $5,197.50 | 7.8× |
| MRI chest w/o contrast (71550) | $841.32 | $2,337 | 3.5× |
| MRI chest with contrast (71551) | $971.19 | $2,697.75 | 1.2× |
| MRI chest wo w contrast (71552) | $1,247.76 | $3,466 | 3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,334.97 | $3,708.25 | 3.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,977.03 | $5,491.75 | 5.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $593.46 | $1,648.50 | 2.5× |
| MRI lumbar spine w contrast (72149) | $1,558.08 | $4,328 | 4.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,556.09 | $7,100.25 | 7.3× |
| MRI orbit face &/neck w/o contrast (70540) | $1,288.44 | $3,579 | 5.4× |
| MRI orbit face neck w contrast (70542) | $1,470.42 | $4,084.50 | 4.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,584.35 | $7,178.75 | 7.4× |
| MRI pelvis w contrast (72196) | $1,676.61 | $4,657.25 | 4.8× |
| MRI pelvis w/o & w contrast (72197) | $1,763.01 | $4,897.25 | 5.0× |
| MRI pelvis w/o contrast (72195) | $1,350.99 | $3,752.75 | 5.6× |
| MRI spectroscopy (76390) | $2,136.51 | $5,934.75 | 24.4× |
| MRI thoracic spine w/o contrast (72146) | $1,271.34 | $3,531.50 | 5.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,592.82 | $4,424.50 | 4.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $696.33 | $1,934.25 | 2.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,041.20 | $5,670 | 5.8× |
| MRI, abdomen, combo (74183) | $2,015.01 | $5,597.25 | 5.7× |
| MRI, dorsal spine combo (72157) | $2,556.09 | $7,100.25 | 7.3× |
| MRI, dorsal spine contrast (72147) | $1,603.71 | $4,454.75 | 4.6× |
| MRI, joint upper extrem (73221) | $775.08 | $2,153 | 3.2× |
| MRI, joint upper extrem combo (73223) | $2,041.20 | $5,670 | 5.8× |
| MRI, lumbar spine combo (72158) | $2,556.09 | $7,100.25 | 7.3× |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$1,120.77–$1,180.17 | $3,113.25–$3,278.25 | varies |
| Myelogram Lumbar (72265) range across 3 matching MRF lines |
$1,703.88–$1,794.24 | $4,733–$4,984 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$257.22–$270.90 | $714.50–$752.50 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$1,954.53–$2,058.12 | $5,429.25–$5,717 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,063.70 | $5,732.50 | 1.6× |
| Myocardial Spect Multiple Studies (78452) | $1,798.38 | $4,995.50 | 1.4× |
| N-invas est c ffr sw aly CTA (75580) | $1,284.84 | $3,569 | 1.5× |
| Neck soft tissue (70360) | $309.24 | $859 | 3.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $604.53 | $1,679.25 | 1.5× |
| Nm csf leak detection (78650) | $1,564.11 | $4,344.75 | 1.2× |
| Nonvascular Shunt X-Ray (75809) | $308.79 | $857.75 | 2.9× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$1,907.73–$1,984.05 | $5,299.25–$5,511.25 | varies |
| Nuclear Rx Intra-Arterial (79445) | $1,040.40 | $2,890 | 4.4× |
| Nuclear Rx Oral Admin (79005) | $356.67 | $990.75 | 1.5× |
| Ob us nuchal meas 1 gest (76813) | $331.29 | $920.25 | 3.2× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $225.09 | $625.25 | 2.1× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $116.46 | $323.50 | 1.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $224.55 | $623.75 | 2.1× |
| Ophthalmic us dx quantitative a-scan only (76511) | $298.98 | $830.50 | 2.8× |
| Optic foramina (70190) | $151.20 | $420 | 1.7× |
| Panoramic X-ray of jaws (70355) | $94.23 | $261.75 | 1.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $808.92 | $2,247 | 1.5× |
| Parathyroid Planar Imaging (78070) | $465.75 | $1,293.75 | 1.2× |
| Parathyroid planar imaging w/wo subtraction (78071) | $604.98 | $1,680.50 | 1.5× |
| Pelvis 1 or 2 views (72170) | $313.47 | $870.75 | 3.0× |
| Perineogram (74775) | $420.93 | $1,169.25 | 1.8× |
| Pet Image Skull-Thigh (78812) | $2,473.02 | $6,869.50 | 1.7× |
| Pet Image W/Ct Lmtd (78814) | $2,460.51 | $6,834.75 | 1.7× |
| PET image w/CT, full body (78816) | $2,840.13 | $7,889.25 | 2.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,525.76 | $7,016 | 1.8× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $2,256.84 | $6,269 | 1.7× |
| PET whole body (78813) | $2,713.41 | $7,537.25 | 1.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,064.76 | $11,291 | 1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $502.11 | $1,394.75 | 1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $434.70 | $1,207.50 | 4.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $383.85 | $1,066.25 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$334.53–$577.98 | $929.25–$1,605.50 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$248.13–$476.46 | $689.25–$1,323.50 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$368.01–$647.46 | $1,022.25–$1,798.50 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $294.03 | $816.75 | 2.8× |
| Radex fingr minimum 2 views (73140) | $233.55 | $648.75 | 2.7× |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$319.14–$541.44 | $886.50–$1,504 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$302.58–$573.75 | $840.50–$1,593.75 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$164.97–$330.03 | $458.25–$916.75 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $325.26 | $903.50 | 3.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $306.18 | $850.50 | 3.5× |
| Radex Ribs Unilateral 2 Views (71100) | $356.22 | $989.50 | 4.1× |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$308.16–$570.78 | $856–$1,585.50 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $87.39 | $242.75 | 1.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $239.67 | $665.75 | 1.4× |
| Radex Spine 1 View Specify Level (72020) | $232.92 | $647 | 2.7× |
| Radex Sternum Minimum 2 Views (71120) | $314.82 | $874.50 | 3.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $179.37 | $498.25 | 2.1× |
| Radex Toe Minimum 2 Views (73660) range across 12 matching MRF lines |
$94.23–$225 | $261.75–$625 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$264.15–$275.04 | $733.75–$764 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$310.50–$610.92 | $862.50–$1,697 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $410.76 | $1,141 | 3.9× |
| Radiation treatment delivery level 1 (77402) | $211.50 | $587.50 | 2.1× |
| Radiation treatment delivery level 2 (77407) | $211.50 | $587.50 | 0.5× |
| Radiation treatment delivery level 3 (77412) | $408.06 | $1,133.50 | 0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $256.05 | $711.25 | 2.4× |
| Radiologic exam colon double contrast study (74280) | $511.02 | $1,419.50 | 2.9× |
| Radiologic exam colon single contrast study (74270) | $342.36 | $951 | 1.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $342.45 | $951.25 | 1.9× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$407.70–$718.29 | $1,132.50–$1,995.25 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $501.03 | $1,391.75 | 4.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $410.76 | $1,141 | 2.3× |
| Radiologic exam swallow function contrast study (74230) | $583.65 | $1,621.25 | 3.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $342.45 | $951.25 | 1.9× |
| Radiologic examination femur 1 view (73551) | $130.32 | $362 | 1.5× |
| Radiologic examination femur minimum 2 views (73552) | $130.32 | $362 | 1.5× |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$309.24–$553.41 | $859–$1,537.25 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $115.65 | $321.25 | 1.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$227.43–$454.95 | $631.75–$1,263.75 | varies |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $776.97 | $2,158.25 | 3.3× |
| Ribs bilateral 3 views (71110) | $303.93 | $844.25 | 2.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,444.77 | $4,013.25 | 3.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,336.03 | $9,266.75 | 6.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,578.69 | $4,385.25 | 2.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,290.77 | $6,363.25 | 4.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,880.82 | $5,224.50 | 1.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,880.82 | $5,224.50 | 1.4× |
| Rp Therapy Intravenous Administration (79101) | $877.50 | $2,437.50 | 3.7× |
| Salivary Gland Function Study (78232) | $917.28 | $2,548 | 2.3× |
| Salivary Gland Imaging (78230) | $917.28 | $2,548 | 2.3× |
| Salivary Gland Imaging Serial Images (78231) | $917.28 | $2,548 | 2.3× |
| Scapula (73010) range across 3 matching MRF lines |
$278.10–$556.38 | $772.50–$1,545.50 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $55.26 | $153.50 | 2.4× |
| Sella turcica (70240) | $94.23 | $261.75 | 1.1× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$213.39–$426.60 | $592.75–$1,185 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$550.35–$1,248.84 | $1,528.75–$3,469 | varies |
| Sialogram (70390) | $527.58 | $1,465.50 | 2.2× |
| Skull less than 4 views (70250) | $147.42 | $409.50 | 1.4× |
| Special dosimetry (77331) range across 2 matching MRF lines |
$229.86–$238.95 | $638.50–$663.75 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$489.96–$509.58 | $1,361–$1,415.50 | varies |
| Special teletherapy port plan (77321) | $238.95 | $663.75 | 0.6× |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$874.26–$909.18 | $2,428.50–$2,525.50 | varies |
| Sternoclavicular joints (71130) | $194.31 | $539.75 | 2.2× |
| Superior sagittal sinus venogram (75870) | $535.50 | $1,487.50 | 0.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $230.76 | $641 | 0.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $149.94 | $416.50 | 0.4× |
| Temporomandble Jt Arthrography Rs&I (70332) | $537.75 | $1,493.75 | 2.2× |
| Testicular Imaging W/Flow (78761) | $1,180.80 | $3,280 | 2.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$560.43–$582.93 | $1,556.75–$1,619.25 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $664.02 | $1,844.50 | 1.8× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $548.82 | $1,524.50 | 3.1× |
| Thoracic spine 2 views (72070) | $293.40 | $815 | 2.8× |
| Thoracic spine 3 views (72072) | $430.29 | $1,195.25 | 4.1× |
| Thoracolumbar 2 views (72080) | $258.12 | $717 | 3.0× |
| Thyroid Imaging With Vascular Flow (78013) | $206.55 | $573.75 | 0.5× |
| Thyroid Met Imaging Body (78018) | $506.34 | $1,406.50 | 0.9× |
| Thyroid Uptake Measurement (78012) | $187.11 | $519.75 | 0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $247.68 | $688 | 0.6× |
| Tx Devices Design & Construction Complex (77334) | $746.10 | $2,072.50 | 2.0× |
| Tx devices design & construction intermediate (77333) | $455.22 | $1,264.50 | 3.4× |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$402.12–$418.14 | $1,117–$1,161.50 | varies |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$252.27–$285.48 | $700.75–$793 | varies |
| Ultrasound Elastography Parenchyma (76981) | $186.84 | $519 | 1.8× |
| Ultrasound Exam Aaa Screen (76706) | $262.62 | $729.50 | 2.5× |
| Ultrasound, abdomen limited (76705) | $250.11 | $694.75 | 2.4× |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$61.92–$179.46 | $172–$498.50 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $105.93 | $294.25 | 1.2× |
| Unlisted fluoroscopic procedure (76496) | $284.94 | $791.50 | 3.3× |
| Unlisted magnetic resonance procedure (76498) | $1,108.80 | $3,080 | 12.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $835.83 | $2,321.75 | 8.2× |
| Unlisted us procedure (76999) range across 3 matching MRF lines |
$104.13–$114.57 | $289.25–$318.25 | varies |
| Upper gi w/o kub (74240) | $342.45 | $951.25 | 1.9× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $194.31 | $539.75 | 17.6× |
| Urea breath test c-14 isotopic analysis (78268) | $174.96 | $486 | 1.9× |
| Ureteral Reflux Study (78740) | $1,180.80 | $3,280 | 2.9× |
| Urethrocystogram voiding (74455) | $698.58 | $1,940.50 | 2.9× |
| Urethrocystography retrograde (74450) | $595.26 | $1,653.50 | 2.5× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$157.05–$168.84 | $436.25–$469 | varies |
| Us chest (76604) | $105.03 | $291.75 | 1.0× |
| Us complete joint (76881) range across 6 matching MRF lines |
$256.95–$362.25 | $713.75–$1,006.25 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$318.06–$330.84 | $883.50–$919 | varies |
| Us head (76506) | $1,689.93 | $4,694.25 | 16.1× |
| Us kidney transplant (76776) range across 3 matching MRF lines |
$421.92–$452.79 | $1,172–$1,257.75 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 7 matching MRF lines |
$272.43–$316.35 | $756.75–$878.75 | varies |
| Us ob detailed single fetus (76811) | $588.69 | $1,635.25 | 2.5× |
| Us ob limited 1 or more fetuses (76815) | $236.52 | $657 | 2.3× |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$221.67–$256.05 | $615.75–$711.25 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$247.14–$256.95 | $686.50–$713.75 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$37.98–$336.69 | $105.50–$935.25 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $322.92 | $897 | 3.1× |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$236.52–$249.57 | $657–$693.25 | varies |
| Us retroperitoneal limited (76775) range across 5 matching MRF lines |
$197.55–$433.26 | $548.75–$1,203.50 | varies |
| Us scrotum and contents (76870) | $532.53 | $1,479.25 | 5.1× |
| Us spinal canal and contents (76800) | $169.56 | $471 | 1.6× |
| Us thyroid (76536) | $417.06 | $1,158.50 | 4.0× |
| Us transrectal (76872) | $331.29 | $920.25 | 3.2× |
| Vascular Flow Imaging (78445) | $945.90 | $2,627.50 | 2.4× |
| Vein X-Ray Chest (75827) range across 4 matching MRF lines |
$872.10–$906.84 | $2,422.50–$2,519 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,313.91 | $3,649.75 | 0.4× |
| Vein X-Ray Spleen/Liver (75810) | $4,064.76 | $11,291 | 1.3× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$831.96–$865.44 | $2,311–$2,404 | varies |
| Venography Adrenal Unilateral (75840) | $2,363.58 | $6,565.50 | 0.7× |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$3,938.49–$4,095.81 | $10,940.25–$11,377.25 | varies |
| Venography extremity bilateral rs&i (75822) | $993.78 | $2,760.50 | 0.6× |
| Venography extremity unilateral rs&i (75820) range across 6 matching MRF lines |
$671.58–$1,313.91 | $1,865.50–$3,649.75 | varies |
| Venography Orbital Rs&I (75880) | $1,313.91 | $3,649.75 | 2.1× |
| Venography Renal Bilateral (75833) | $4,064.76 | $11,291 | 1.3× |
| Venography Renal Unilateral (75831) | $2,108.25 | $5,856.25 | 0.7× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$2,727.18 | $7,575.50 | 0.5× |
| Vertebral fracture assessment via dxa (77086) | $131.40 | $365 | 1.5× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$228.78–$457.20 | $635.50–$1,270 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $246.42 | $684.50 | 2.8× |
| X-ray antegrade pyelogram tube (74425) range across 7 matching MRF lines |
$637.38–$686.97 | $1,770.50–$1,908.25 | varies |
| X-Ray Aorta Leg Arteries (75630) | $2,380.32 | $6,612 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $433.26 | $1,203.50 | 4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$244.08–$487.98 | $678–$1,355.50 | varies |
| X-Ray Exam Breast Specimen (76098) | $209.16 | $581 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $113.40 | $315 | 1.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $215.19 | $597.75 | 2.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $410.76 | $1,141 | 3.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $130.32 | $362 | 1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $130.32 | $362 | 1.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $215.19 | $597.75 | 2.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $215.19 | $597.75 | 2.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $215.19 | $597.75 | 2.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $410.76 | $1,141 | 3.9× |
| X-Ray Exam L-S Spine Bending (72114) | $585.36 | $1,626 | 5.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $352.62 | $979.50 | 4.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $574.02 | $1,594.50 | 5.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$151.20–$219.42 | $420–$609.50 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$94.23–$206.64 | $261.75–$574 | varies |
| X-ray head for orthodontia (70350) | $94.23 | $261.75 | 1.1× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$271.98–$543.69 | $755.50–$1,510.25 | varies |
| X-ray IV pyelogram (ivp) (74400) | $247.68 | $688 | 1.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $113.22 | $314.50 | 1.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $297.72 | $827 | 3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $346.68 | $963 | 3.3× |
| X-ray nose-rectum child f.b. (76010) | $192.60 | $535 | 2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $468.18 | $1,300.50 | 4.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $199.26 | $553.50 | 1.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $118.17 | $328.25 | 1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $78.30 | $217.50 | 0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $209.70 | $582.50 | 2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $331.38 | $920.50 | 3.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $559.89 | $1,555.25 | 1.6× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$102.06–$164.43 | $283.50–$456.75 | varies |
| X-Rays Bone Survey Complete (77075) | $678.96 | $1,886 | 6.5× |
| Xr c-spine 4 or 5 views (72050) | $532.26 | $1,478.50 | 5.1× |
| Xr facial bones less than 3 views (70140) | $206.64 | $574 | 2.4× |
| Xr orbits complete 4 views (70200) | $321.48 | $893 | 3.1× |
| Xr Tomogram Single Plane (76100) | $151.20 | $420 | 1.4× |
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.